Increase In Poverty Rate Research Articles

Path Dependency and the Neighbourhood Effect: Urban Poverty in Impoverished Neighbourhoods in Chinese Cities

In this paper we examine poverty concentration in Chinese impoverished neighbourhoods and estimate the effects of household characteristics and neighbourhood types on social deprivation. We find that unemployed households in old neighbourhoods are among the most deprived. The Chinese case suggests that urban poverty is concentrated by particular social groups living in specific neighbourhoods. We find a small but not insignificant neighbourhood effect on poverty generation in China. Living in impoverished neighbourhoods increases the probability of becoming poor by a steady percentage. For every 1% increase in poverty rate, the chance is raised by 4.4%. Living in old neighbourhoods and being unemployed raises the chance by 4.7 times with demographic and socioeconomic attributes controlled for. The neighbourhood effect in the Chinese case is linked to path dependency of institutionally derived inequalities.

Nickel and Dimed German Style: The Working Poor in Germany

Using data from the German SOEP, this paper analyses whether there have been (a) any significant changes in poverty rates and poverty intensities before and after the Hartz IV reforms and (b) whether there have been observable changes in the effect of employment in reducing the threat or intensity of poverty. Using multivariate analyses we can find no evidence of increases in poverty rates comparing the time period 2002–2004 with that of 2005-2006. Further we find no change in the effect of employment in reducing the probability and intensity of poverty during this time period. The “working poor” phenomenon in Germany remains relatively small and statistically unchanged by the Hartz reforms.

Forecasting Behavioural and Distributional Effects of the Bofinger-Walwei Model using Microsimulation

Summary Since Germany’s social assistance reform (“Hartz-IV-Reform”) in 2005 there has been a strong increase in the number of working poor and long-term unemployed. This development is often attributed to the remaining disincentives of the reformed social assistance to take up a low-paid full time job. Therefore, several proposals have been worked out to reduce these disincentives. In this paper we analyse an in-work benefit programme considered by the German government, which follows the proposal of Bofinger et al. (2006). We employ a microsimulation model for estimating labour supply as well as distributional and fiscal effects of this reform proposal.We provide “morning after effects”, i.e. fiscal effects without considering behavioural adjustments, and long run effects, which take into account the labour supply response following the introduction of the reform.We predict the labour supply responses by estimating a discrete choice model for different household types and find a moderate increase in labour supply (103,000 full-time equivalents) as well as overall low negative participation effects. The distributional analysis reveals an overall increase in poverty rates caused by lower earnings disregards as well as substantial deadweight losses, since a large part of the in-work benefit accrues to households who do not belong to the working poor in the status quo.

Incorporating Community-Academic Partnerships into Graduate Medical Education

Incorporating Community–Academic Partnerships into Graduate Medical Education Dodi Meyer, MD, Anne Armstrong-Coben, MD, and Milagros Batista, MSW Our nation's health is challenged by the persistence of health disparities, lack of universal health insurance, and increasing poverty rates. There is an unprecedented contrast between the sophisticated technology used to treat strictly "medical" conditions and the tools needed to treat problems such as obesity, substance abuse, and domestic violence, which are deeply rooted in social conditions.1 Even when the knowledge base exists regarding how to treat these conditions, a gap exists in how these services are translated to the individual patient and communities as a whole. This gap is being addressed in a number of ways. Accrediting bodies at the undergraduate and graduate levels now require that community health and cultural competency be incorporated into training. Recently, the Liaison Committee on Medical Education recommended that "medical schools should make available sufficient opportunities for medical students to participate in service-learning activities."2 In support of such training initiatives, federal agencies and private foundations have been promoting translational research, service learning, community-based participatory research (CBPR), and community-engaged scholarship in the health care professions. Despite these efforts, training still occurs mostly within hospital walls. Furthermore, many academic institutions remain resistant to viewing community-based education, research, and service as a credible and valid way to address the issues at hand. Community–academic partnerships, for the most part, stem from either individual, passionate leaders or the political need of a particular institution rather than being universally held as an integral part of the mission of an academic medical center. In this issue of the Progress in Community Health Partnerships, we can learn from two successful initiatives geared towards creating a health care work force that can effectively combine knowledge with action to achieve social change to improve health outcomes and eliminate health disparities.3 Doctor Earnestine Willis and her colleagues describe a successful, sustainable, integrated program for pediatric residents where the community has active participation in the design, implementation, and evaluation of the pediatric training program.4 The tension between creating community projects that meet the self-identified needs of the community and the outside perceived needs of the academic institution seems to be resolved. Both community and university members learn from each other's culture; the learning is reciprocal. The use of parent trainers, described in this article, is of utmost importance in ensuring that health professionals are always in tune with the patient and community perspectives. In Dr. Debbie Salas-Lopez and her co-worker's article, there is an important attempt to understand health beliefs regarding cancer screening among Latinos, a group that suffers from lower screening rates even though the incidence of some cancers is higher than in the general population.5 Learning the patient's perspective is an essential first step when addressing the differential diagnosis of perceived patient nonadherence.6 Health care providers, and especially trainees, frequently get frustrated when patients do not follow their advice. They rarely take a step back to reflect on why this is the case. Running focus groups with patients or community members can inform providers about the barriers patients and communities face with recommended medical treatments. Issues of culture, language, health literacy, and socioeconomic constraints need to be addressed if we want our interventions to have a meaningful effect. With most visits limited to a 15-minute encounter, we need to develop tools that physicians-in-training can use to elicit the information needed. Studies such as Dr. Salas-Lopez and associate's are a step toward understanding and defining [End Page 207] the types of skills that these physician-trainees need to learn to accomplish this. Many challenges arise when incorporating community– academic partnerships into graduate medical education. Communities are at different developmental stages with regard to their resources, knowledge of health threats, and ability to overcome the historical mistrust existing between them and their neighboring academic center. Community agencies have to be willing to use their manpower in the training of physicians and to dedicate time to CBPR when traditionally they are service driven. Universities have different levels of commitment to their surrounding community. Financial...

Distance to Diagnosing Provider as a Measure of Access for Patients With Melanoma

To examine the effect of travel distance and other sociodemographic factors on access to a diagnosing provider for patients with melanoma. Analysis was performed of all incident cases of melanoma in 2000 from 42 North Carolina counties. Academic research. Patients and providers from 42 North Carolina counties were geocoded to street address. Associations between Breslow thickness and clinical and sociodemographic factors (age, sex, poverty rate, rurality, provider supply, and distance to diagnosing provider) were examined. Of 643 eligible cases, 4.4% were excluded because of missing data. The median Breslow thickness was 0.6 mm (range, 0.1-20.0 mm). The median distance to diagnosing provider was 8 miles (range, 0-386 miles). For each 1-mile increase in distance, Breslow thickness increased by 0.6% (P =.003). For each 1% increase in poverty rate, Breslow thickness increased by 1% (P =.04). Breslow thickness was 19% greater for patients aged 51 to 80 years than for those aged 0 to 50 years (P =.02) and was 109% greater for patients older than 80 years than for those aged 0 to 50 years (P < .001). Sex, rurality, and supply of dermatologists were not associated with Breslow thickness. For patients with melanoma, distance to the diagnosing provider is a meaningful measure of access that captures different information than community-level measures of rurality, provider supply, and socioeconomic status. Future work should be targeted at identifying factors that may affect distance to diagnosing provider and serve as barriers to melanoma care.

Changes in population characteristics and their implication on public health research

Population estimates are generally drawn from one point in time to study disease trends over time; changes in population characteristics over time are usually not assessed and included in the study design. We evaluated whether population characteristics remained static and assessed the degree of population shifts over time. The analysis was based on the New York State 1990 and 2000 census data with adjustments for changes in geographic boundaries. Differences in census tract information were quantified by calculating the mean, median, standard deviation, and the percent of change for each population characteristic. Between 1990 and 2000, positive and negative fluctuations in population size created a U-shaped bimodal pattern of population change which increased the disparities in demographics and socioeconomic status for many census tracts. While 268 (10%) census tracts contracted by 10%, twice as many census tracts (21%, N = 557) grew at least 10%. Notably, the non-Hispanic African-American population grew 10% or more in 152 tracts. Although there were overall reductions in working class and undereducated populations and gains in incomes, most census tracts experienced growing income inequalities and an increased poverty rate. These changes were most pronounced in urban census tracts. Differences in population characteristics in a decade showed growing disparities in demographics and socioeconomic status. This study elucidates that important population shifts should be taken into account when conducting longitudinal research.

Sociodemographic factors influencing Breslow thickness at diagnosis for patients with melanoma

6552 Background: In previous work, we demonstrated that Breslow thickness at diagnosis is significantly related to distance to provider for patients with melanoma in North Carolina (NC). Expanding the study population to include patients in New Jersey (NJ) and southern California (CA), we hypothesize that distance to provider is an effective measure of access to melanoma care regardless of geographic region. Methods: An IRB-approved secondary data analysis was performed of all incident cases of invasive cutaneous melanoma in 2000 from 3 population-based ascertainment areas (CA, NC, NJ). Patients and providers were geocoded to street address; Euclidian distances between patients and providers were calculated. The outcome variable, Breslow thickness at diagnosis, was logged for analysis. Simple and multiple linear regression were used to test associations between Breslow thickness and multiple sociodemographic factors. Results: Of 1,408 eligible cases, 16% were excluded for missing Breslow data. Median Breslow thickness was 0.6 mm (range 0.01–30.0 mm). Median distance to provider was 7 miles (range 0–372 miles). There was no significant difference in Breslow between the 3 geographic regions. Males had on average 15.5% thicker tumors than females, p=0.009. Patients 51–80 years old had 15.3% thicker tumors than patients =50, p=0.015, and those &gt;80 had 64.3% thicker tumors than patients =50, p&lt;0.001. For all patients, Breslow thickness increased only 2% for each 10 mile increase in distance, p=0.047. However, when limited to patients from rural areas, each 10 mile increase in distance corresponded to an 8% increase in Breslow, p&lt;0.001. Meanwhile, Breslow was not associated with any area-based measures of rurality or provider supply. Each 1% increase in poverty rate corresponded to a 1% increase in Breslow, p=0.036. Conclusion: Breslow thickness at diagnosis is strongly correlated with distance to provider, especially for patients from rural areas. Distance to provider is a better measure of access to melanoma care than area-based measures of rurality. No significant financial relationships to disclose.

POVERTY IN POLAND DURING THE 1990s: ARE THE RESULTS ROBUST?

This study examines the robustness of poverty measures for Poland in the 1990s to employed methods. At least two definitions or techniques of estimation are applied to each of the following components of poverty measures: (1) household well‐being; (2) poverty line; (3) equivalence scales; and (4) poverty index. Furthermore, groups at risk of poverty are selected by means of decomposition of the poverty incidence and by estimation of the probit model. Relatively robust conclusions can be reached for trends in absolute poverty incidence, which show an inverted U‐shape with rapidly increasing poverty rates in 1993–1995 and declining rates since, but with continued increases in relative poverty. Some robust correlates of high poverty (low education, unemployment, rural residence, large number of children) are also found.

Analysis of relationship between distance to diagnosing provider and Breslow depth at diagnosis

6018 Background: Mediators of access to medical care, such as geographic isolation, rurality and socioeconomic status, have been associated with stage at diagnosis, treatment, clinical trial involvement and prognosis for various cancers. For melanoma, little is known about the relationship between mediators of access and various outcome measures. We hypothesize that Breslow depth at diagnosis is related to the distance patients travel to reach their diagnosing providers. Methods: An IRB-approved secondary data analysis was performed of all incident cases of invasive cutaneous melanoma in 2000 from a 42 county ascertainment area. Patients and physicians were geocoded to street address; Euclidian distances between patients and providers were calculated. The outcome variable, Breslow depth at diagnosis, was logged for analysis. Simple and multiple linear regression were used to test associations between Breslow depth and distance to provider, age, gender, census tract poverty rate, rurality and availability of local dermatologists. Results: Of 655 eligible cases, 6% were excluded for missing histopathologic data. Median Breslow depth was 0.6mm (mean 1.1±1.6; range 0.1–20.0mm). Median distance to provider was 8 miles (mean 15±31; range 0–386 miles). For every ten mile increase in distance, Breslow depth increased by 6% (p=0.002). For every 10% increase in poverty rate, the Breslow depth increased by 10% (p=0.041). The relationship between Breslow depth and age wasn’t linear: depth was 17% greater for patients 51–80 than for those ≤50 (p=0.016), while depth was 74% greater for patients >80 than for those ≤50 (p<0.001). Gender, rurality, and availability of local dermatologists were not significantly associated with Breslow depth. On multivariate analysis, the associations between Breslow depth at diagnosis and distance to provider (p=0.002) and age (p<0.015) were significant. Conclusions: Distance to provider may be a significant measure of access to melanoma care that captures different information than proxy measures of rurality, poverty, and local availability of providers. Further research is needed to elucidate factors that mediate how far patients travel to reach their diagnosing providers. No significant financial relationships to disclose.

East European protest politics in the early 1990s: comparative trends and preliminary theories

TRANSITIONS TO DEMOCRACY have often been accompanied by intense political disruption. As they involve expanding political opportunities for many groups, such transitions have frequently led to a higher incidence of protests and to the emergence of more disruptive and violent forms of protest (Tarrow, 1989; Tilly, 2003). Democracies can also be expected to be more protest-prone on aggregate because they tend to bestow greater freedoms of expression on their citizens. In a large-scale quantitative analysis spanning regimes around the globe over 40 years, Przeworski et al. (2001) find that in regimes that can be characterised as democratic rather than dictatorial, strikes have historically been almost three times as frequent and demonstrations and riots almost twice as frequent. During the 1970s and 1980s many reforming countries in Latin America, Africa and Asia experienced major waves of strikes, demonstrations and riots. On a number of dimensions, Central and Eastern European countries in the early 1990s were characterised by similar structural variables as in these earlier reform cases, including rising unemployment, falling real incomes, increasing poverty rates and government subsidy cuts. Many observers thought the new post-socialist democracies were also likely to be confronted with scenarios of large-scale disruption and contention. This article indicates that, despite the above, post-socialist transitions have been comparatively peaceful in terms of strike action. It furthermore offers a critical review of some existing theoretical explanations of this puzzle, and briefly suggests directions for further research.

Evolution of Poverty During the Crisis in Indonesia

The economic crisis caused a clear deterioration in the welfare of the Indonesian people. In this paper, we examine the appropriate method to compare the change in poverty rates over time. We then piece together a consistent series of estimates of poverty rates during the crisis from various sources, covering a period from February 1996 to February 2002. The reconciliation of these various estimates paints a very reasonable picture and neatly tracks events. The poverty rate increased from the lowest point of approximately 15% at the onset of the crisis in the middle of 1997 to the highest point of approximately 33% nearing the end of 1998. This maximum increase in poverty rate during the crisis of 18 percentage points implies that approximately 36 million additional people were pushed into absolute poverty due to the crisis. After the peak point, the poverty rate started to decline again and reached the pre‐crisis level of approximately 15% at the end of 1999, implying that the lost time in poverty reduction due to the crisis was approximately 2.5years. However, the poverty rate after this point appears to have fluctuated. During 2001 and early 2002, poverty was on the rise again.

Treatment Effect Heterogeneity in Theory and Practice

Instrumental Variables (IV) methods identify internally valid causal effects for individuals whose treatment status is manipulable by the instrument at hand. Inference for other populations requires some sort of homogeneity assumption. This paper outlines a theoretical framework that nests all possible homogeneity assumptions for a causal treatment-effects model with a binary instrument. The framework suggests strategies for using IV estimates for extrapolation, while making it clear that efforts to go from local average treatment effects (LATE) to population average treatment effects are inherently speculative. These ideas are illustrated in an application using sibling-sex composition to estimate the effect of child-bearing on economic and marital outcomes for mothers with two or more children. The application is motivated by welfare reform, which penalizes further childbearing by welfare mothers on the grounds that more children make continued poverty and welfare receipt more likely. The empirical results generally support the notion of reduced labor supply and increased poverty rates as a consequence of additional childbearing, but evidence on the impact of childbearing on marital stability and welfare use is more tenuous. Another interesting finding is that for the sample of teen mothers, LATE is essentially equal to the population average treatment effect.

A Threat to Social Security? the Impact of Eu Membership on the Finnish Welfare State

In the fifth year of membership of the EU, the Finnish welfare state shows no serious signs of erosion. Furthermore, the changes that have taken place in Finnish social policies are largely due to factors separate from EU and EMU membership. As the extent and the effects of EU social policy are very limited and as EU social policy does not for the most part fall within the traditional definition of social policy (a structure of transfers and services aimed at redistribution among the entire population), this article focuses mainly on the indirect effects of EU and EMU membership, on Finnish social policies. This article argues that while social policy restructuring was frequently explained and justified by politicians on the grounds of EU membership, and while central decisionmakers were obviously very determined to meet the convergence criteria, the pressures to fulfil certain macroeconomic criteria, similar to the convergence criteria, would have existed in the absence of any intention to join the EU. The main motives for welfare state restructuring were the recession that eroded the financial basis of the welfare state, and the changed rules of macroeconomic management that rendered a number of economic and social policy responses to economic crises redundant. Furthermore, the logic and details of social policy restructuring can only be understood in the light of domestic social policy structures, institutions, and political legacies.2 The article first describes the changes that have taken place in Finnish social policy in the 1990s; then examines the expected and actual social policy consequences of EU and EMU; and concludes by emphasizing the role of domestic actors as agents of Europeanization. The Finnish welfare state has not undergone systemic change as a result of the restructuring in the 1990s. Finland continues to have a distinctly encompassing model of social provision. The universal character of certain benefits has been eliminated (the national pension and basic sickness benefit) but the impact of this on benefit recipients has not been great.3 Earnings-related benefits continue to provide income replacement at a relatively high level and hence discourage private insurances. Benefits of last resort are now more tightly means-tested, but they still prevent increases in poverty rates effectively. International statistics show that Finland is still one of the world leaders in welfare expenditure (OECD Economic Surveys, Finland, 1998; OECD Economies at a Glance, Structural Indicators, 1996; OECD Historical Statistics, 1997). Relatively equal income distribution, low poverty rates, world-class standards in public services, and many other facts testify to the robust health of the Finnish welfare state (Ministry of Social Affairs and Health, 1996a: 96; Ministry of Social Affairs and Health, 1998a: 5; 1998b: 12). This is particularly impressive in the light of the extremely heavy pressures put on the social EUROPEAN BRIEFING

Migration Patterns and the Growth of High‐Poverty Neighborhoods, 1970‐‐1990

Using geocoded data from the Panel Study of Income Dynamics, this article examines why the number of high‐poverty neighborhoods in American cities has increased since 1970. The main findings are (1) the migration of the nonpoor away from moderately poor neighborhoods has been a key process in forming new high‐poverty neighborhoods, although in the early 1980s increasing poverty rates were also important; and (2) African‐Americans have moved into predominately white neighborhoods at a pace sufficient to increase their numbers there, but neighborhoods with increasing black populations tend to lose white population rapidly. Implications for theories of poor neighborhoods are discussed.

Do Low-Income Families Benefit from Minimum Wage Increases? Evidence from State-Level Minimum Wage Laws

Several recent studies contend that falling real minimum wage rates are an important factor behind rising wage inequality and increasing poverty rates. Other studies find the more conventional result that they have very little influence on poverty and inequality, but these studies are generally based on simulated labor market responses. This study examines the influence of minimum wage rates on poverty rates and family income inequality using state-level minimum wages. The methodology has the key advantage of not requiring simulated labor market responses to minimum wage increases. The results suggest that increases in minimum wage rates and coverage do not reduce poverty rates or income inequality.

A model of state-level prescription drug expenditures in the USA

Research is scanty on pharmaceutical care expenditures of developed nations. This paper models the determinants of state-level prescription drug expenditures for the USA, based on pooled data for 1980, 1982, 1984, 1988 and 1990. The GLS regression results indicate that older adults age 65 or more, Medicaid recipients and realincome are strongly significant determinants. With the growing proportion of the elderly and the increasing poverty rates among Medicare and Medicaid recipients, pharmaceutical care reform proposals need to focus on preventive care, rather than expensive treatments.

Poverty Among Southern Workers: Metro and Nonmetro Differentials

quired to sustain a minimally adequate standard of living. It is still pervasive in our society and affects more than 13% of the population (over 32 million people). The American public customarily perceives poverty as a metro2 problem. However, the poverty rate has been higher in nonmetro than in metro areas since 1959, the first year for which poverty data are available using the official government definition (USDA). Further, according to the 1992 U.S. Bureau of the Census, poverty rates continued to be more severe in nonmetro areas than in metro areas. The 1992 nonmetro poverty rate was 16.8%; 2.9 percentage points higher than the metro rate of 13.9% (U.S. Bureau of Labor Statistics). Geographically, the South3 continues to have the highest poverty rate, 16.9% in 1992. Moreover, the South continues to have the highest nonmetro black poverty rate, around 40%, and over 90% of poor nonmetro blacks reside in the South. The census data also indicate that each population group (female head of household, married couples, related children, whites, blacks, Hispanic, and elderly/aged) had a higher poverty ate in nonmetro areas in 1992 than in metro areas; the increases in poverty rates since 1973 have been unevenly distributed across all groups. For instance, since 1987, the poverty rate for nonmetro female heads of households

Poverty in Eastern Europe in the Years of Crisis, 1978 to 1987: Poland, Hungary, and Yugoslavia

Eastern Europe experienced an economic crisis between 1978 and 1987. Declining income led to substantial increases in poverty rates in Poland and Yugoslavia, while poverty in Hungary remained at about the same level as before the crisis. In all three countries urban poverty increased, as the economic condition of state sector workers deteriorated to a much greater extent than that of agricultural and mixed households. The increased poverty was entirely explained by declining income, because the overall income distribution did not change or in some cases improved.

The New Age Structure of Poverty in America: Permanent or Transient?

Building on an interpretation of a numbr of recent economic and demographic changes previously advanced by this writer (Easterlin 1987) this analysis covers the causes of the new age structure of poverty especially the increased poverty rate of children and the prospects for its continuation over the rest of the 20th century. In contrast to the view that the gains of either the children or the elderly have been at the expense of the other group i.e. expanded government programs underlying the improved status of the elderly have been purchased by sacrificing programs for the young it is suggested that the divergent trends in poverty rates of children and the elderly chiefly reflect 2 different and largely independent causes: the improved status of the elderly is attributable largely to government action especially advances in social security; and the rise in the poverty rate of children is to an important extent a result of market forces and would have occurred even in the absence of programs improving the lot of the elderly. The base period for most of this analysis is the late 1960s when annual series on poverty rates of persons by age and on income by family status and age first became available. Families and unrelated individuals are classified as being in poverty if their money income (including retirement and disability pensions government cash-transfer payments alimony and child support) falls below a threshold level based upon the Department of Agricultures Economy Food Plan. The rise in the poverty rate of children is part of a broader pattern of shifting poverty status of young versus old. The increase in poverty rates from 1968-85 is progressively smaller with age and for those aged 55 and older the poverty rate decreases absolutely. In 1968 the highest poverty rate 25% was found among the elderly those 65 and older; children the only other above-average group had a rate of about 15%. As a result of the disparate trends by age the elderly now have a below-average rate less than 13%. For those under age 65 divergent trends in poverty rates by age are at bottom a reflection of similar labor market trends. Real wage rates of younger males as measured by year-round full-time income have declined noticeably relative to older males. Younger females also show deterioration in real wages relative to those of older females but the magnitude is less. The labor market conditions of younger adults have affected their poverty rates not only directly through their impact on income within given types of families but also indirectly by shifting the family-type distribution toward female-headed families. Childrens poverty rates have suffered more than those of younger adults because of the more severe impact on children of the shifts in demographic structure.

The world economic crisis and the children: United States case study.

This is a review of the United States experience with issues of child health and services as they relate to changes in economic trends. No existing data systems are entirely adequate for reporting on the current health status of children. An important consideration for the monitoring of children's health in the United States is the status of subgroups such as those who are disadvantaged for reasons of poverty, discrimination or geographic isolation. Ample evidence confirms that children living in poverty suffer adverse health consequences and that the proportion of children living in poverty in the United States has increased steadily since 1975 and dramatically since 1981. Most measures of health status and health risks for children show steady improvements throughout the 1970s. The exercise of public responsibility for financing and providing essential services and supports held constant or improved during this period, especially during the recession of 1974-75. The health status and risks for children since 1981 appear to be adversely affected which must be attributed to a combination of circumstances that include serious recession, increased poverty rates for households with children and diminished health benefits and social support services. These findings suggest that when either local or widespread economic reversals are anticipated, health services and social supports for children need to be expanded rather than contracted.