Low-income Households Research Articles

Elevating property management in public housing: A systematic literature review

Public housing (PH) focuses on assisting low-income households with housing stability. However, the inefficiency of property management in PH gives rise to a range of challenges in both physical and internal operational management, leading to negative stigmatisation towards tenants living in PH. Various initiatives have been launched to address the inefficiencies of property management. This study categorised and elaborated these initiatives under three main categories: reconceptualisation, externalisation, and managerialisation. There is currently no systematic literature review that provides a comprehensive overview of the initiatives aimed at enhancing property management in PH on a global scale, despite the fact that an overwhelming number of initiatives have been proposed in various studies. Therefore, the present systematic literature review was conducted to provide a comprehensive understanding of the existing research and initiatives pertinent to PH property management. This thorough examination will not only inform the current state of property management practices but also provide valuable insights to guide future research endeavours and decision-making processes in this domain. The outcome of this study revealed the positive impact of managerialisation, showcasing its pivotal role in problem identification and as a strategic indicator for proposing solutions aimed at continuous improvement.

Understanding Food Insecurity and Participation in Food Assistance Programs among Hispanic/Latino Residents of Hialeah, Florida, before and during the COVID-19 Pandemic

The 63.6 million Hispanic individuals living in the United States constitute the largest ethnic or racial minority group in the country. Hispanic/Latino households report a high prevalence of food insecurity, and often, food-insecure individuals cope by turning to emergency and federal food assistance programs for immediate or long-term assistance. This paper focuses on Hialeah, Florida, a predominantly Hispanic/Latino city in Miami-Dade County. It examines which demographic factors influence participation in food assistance programs and the occurrences of periods of disrupted food access. This study examines two questions: (1) What factors are associated with participation in food assistance programs? (2) To what extent did study participants use food assistance programs before and during the COVID-19 pandemic? We conducted a survey and collected 684 responses from April to August 2022. We gathered data on participants’ identities, household attributes, and their usage of federal and emergency food assistance programs. We used Pearson’s chi-square tests to identify significant associations between food assistance usage, food access, and respondents’ demographic characteristics. We also used binary logistic regression models to assess probabilities. The findings of this research are significant, indicating that the COVID-19 pandemic exacerbated food access challenges in Hispanic/Latino households in 2022. The data also revealed that low-income households, respondents below the age of 40, individuals born in the United States, those with low educational attainment, and those living in multifamily households had the highest likelihood of using food assistance programs. Single- and non-single-parent households, employment status, languages spoken at home, and number of children in the household were also statistically significant factors in predicting food assistance usage. This research provides valuable insights into how individuals in a city responded to the pandemic by utilizing food assistance programs.

Household’s Characteristics and Learning Poverty: An Empirical Study

‘Learning poverty’ among school students is a cause of concern. Studies of family effects on students’ learning outcomes in the context of North-eastern region of India and Meghalaya are significantly lacking. The present study is about ‘learning poverty’ and its relationship with household characteristics such as household-income, parents’ educational level, parents’ occupation, nature of residence and number of siblings in the context of the Khasi–Jantia tribes of Meghalaya, which follows a matrilineal system. From the field experiment conducted on 407 students of classes 9 and 10 from 15 randomly selected schools from Shillong and Jowai towns, the findings indicate that ‘learning poverty’ is significantly higher in proportion for students belonging to the lower household-income groups. Besides low household-income, low level of parents’ education, not having and staying in one’s own house, higher number of siblings and parents’ occupation in low-end wage employment have emerged as critical factors responsible for the presence of ‘learning poverty’. The study recommends that policymakers and school management consider family effects seriously and work with parents from poor households to improve learning outcomes, mitigating the menace of ‘learning poverty’ on the society. However, the results of the study need to be examined with one caveat that it has not taken into consideration the school effects, which could too impact learning outcomes. JEL Codes: I240, I250, I210

Analyzing the Impact of Government Subsidies on Household Welfare during Economic Shocks: A Case Study of Iran

The study evaluates the effectiveness of Iranian government subsidies for households by comparing the welfare impact of food price shocks with the subsidy payments they receive. This helps us assess the government's efforts to reduce poverty in Iran. The household cost data in 2020 was used to calculate compensated price elasticities using the Quadratic Almost Ideal Demand System (QAIDS). Results showed negative and less than one own-price elasticities for all food items, with a sensitivity to changes in income greater than one for demand of cereals, cooking oil, and fruits. Then, compensated variations (CV) welfare index was used to evaluate the effectiveness of government support payments in reducing household vulnerability due to food price increases. The results showed that the CV fluctuates between 8.05-80.46 $ under different scenarios. In other words, consumers are in a worse situation in terms of welfare and their expenditure increases. The vulnerability index of low-income households, after applying different food price scenarios, is in the range of 1.46-14.67%, which is reduced to 1.35-14.53% by implementing the cash-targeted subsidy policy. In other words, the effectiveness of the government's subsidy policy of $19 per person could reduce the vulnerability of these households by only 0.14%.

Horizontal Inequality in Healthcare Utilisation in Rural Sabah, Malaysia

Ensuring universal access to healthcare is essential for societal equity. However, significant inequalities exist within global healthcare systems, resulting in unequal access to services and divergent health outcomes. Socioeconomic inequity, poor living conditions, and inadequate healthcare infrastructure perpetuate poor health among poor communities. Despite greater healthcare needs, economically disadvantaged populations face substantial barriers to obtaining necessary services. This research evaluates the equitable aspect of healthcare utilisation in Sabah’s rural areas to guide policy formulation. Nabawan, a rural area in Sabah with high poverty rates, was selected to assess income-related inequality and inequity in healthcare utilisation. Using the horizontal equity index and decomposition analysis, it was found that economic status significantly influences healthcare distribution, typically favouring the affluent. Central to this analysis is the concept of “equal treatment for equal need,” ensuring individuals with similar healthcare needs receive similar care regardless of economic status. Results indicate that wealthier individuals are slightly more likely to utilise healthcare services, although the difference is minimal. To address disparities, enhancing targeted financial assistance programs like PeKa B40 could reduce out-of-pocket expenses for low-income households. Additionally, increasing healthcare funding for rural infrastructure and training local healthcare workers can ensure equitable access for all households.

Prevalence and Associated Risk Factors with Unawareness of Folic Acid Benefits Prior to Pregnancy: Results From Canadian Community Health Survey

Recent national studies on awareness of folic acid (FA) prior to pregnancy among Canadian women are lacking. Using the 2017–2018 Canadian Community Health Survey, we aimed to estimate prevalence and risk factors associated with Canadian women who reported they were unaware of the benefits of FA supplementation before pregnancy. Prevalence of unawareness of FA was 22.1%. Lower education, lack of a health care provider, low household income, and an immigrant background were associated with greater odds of unawareness of the benefits of FA supplementation. Persistent associations with measures of social disadvantage and social determinants of health emphasize the need for new targeted public health campaigns.

Survival of Children With Critical Congenital Heart Defects in the National Birth Defects Prevention Study.

Critical congenital heart defects (CCHDs) are associated with considerable morbidity and mortality. This study estimated survival of children with nonsyndromic CCHDs and evaluated relationships between exposures of interest and survival by CCHD severity (univentricular or biventricular function). This analysis included 4380 infants with CCHDs (cases) born during 1999-2011 and enrolled in the National Birth Defects Prevention Study, a multisite, population-based case-control study of major birth defects. Cases were linked to state death files. Nonparametric Kaplan-Meier survival functions were used to estimate 1- and 5-year survival probabilities overall and by severity group (univentricular/biventricular) stratified by demographic and clinical exposure variables of interest. The log-rank test was used to determine whether stratified survival curves were equivalent. Survival and 95% confidence intervals (CIs) were also estimated using Cox proportional hazards modeling adjusted for maternal age, education, race/ethnicity, study site, and birth year. One- and five-year survival rates were 85.8% (CI 84.7-86.8) and 83.7% (CI 82.5-84.9), respectively. Univentricular 5-year survival was lower than biventricular case survival [65.3% (CI 61.7-68.5) vs. 89.0% (CI 87.8-90.1; p < 0.001)]. Clinical factors (e.g. preterm birth, low birthweight, and complex/multiple defects) were associated with lower survival in each severity group. Sociodemographic factors (non-Hispanic Black race/ethnicity, <high school education, smoking, and lower household income) were only associated with survival among biventricular cases. Mortality among children with CCHDs occurred primarily in the first year of life. Survival was lower for those with univentricular defects, and social determinants of health were most important in predicting survival for those with biventricular defects.

Online retail nudges to help parents with lower-income choose healthy beverages for their children: A randomized clinical trial.

Nudges offer a promising tool to reduce sugary drink intake among children who are most at risk for diet-related disease. To examine the impact of online store nudges on purchases of sugary drinks for children in lower-income households. Caregivers with lower-income were recruited to an online shopping experiment and instructed to spend $10-$30 on three beverages for their child aged 1-5 years. Participants were randomized to navigate an online supermarket in its standard version (n = 1106) or a version with nudges (n = 1135), including a product placement nudge (i.e. placing healthy beverages in prominent positions) and a swap nudge (i.e. offering a swap of water, plain milk and/or 100% fruit juice upon selection of sugary drinks). On average, participants purchased 1887 (SD = 2113) and 620 (SD = 1528) calories from sugary drinks per basket in the control and experimental conditions, respectively. Model-based results indicate that those in the experimental condition purchased 1267 (95% CI: 1419, 1114) fewer calories from sugary drinks, and fewer grams of total sugar (β = -253.5 g (95% CI: -286.3, -220.6)) and added sugar (β = -287.8 g (95% CI: -323.1, -252.5)) purchased from sugary drinks. Nudges may be an effective, acceptable, scalable strategy for leading caregivers in lower-income households to purchase fewer sugary drinks for their children.

Does digital credit alleviate household income vulnerability?

As a result of various internal and external risks and unstable expectations, the income vulnerability of households in various countries has come to the forefront, weakening the microfoundation of a stable macroeconomy. However, the booming development of digital credit may create favorable conditions for mitigating household income vulnerability and improving household economic resilience. Using data from the 2014–2020 China Family Panel Studies (CFPS), this paper explores the mechanism of the role of digital credit on household income vulnerability. Firstly, digital credit can help the household sector manage risks, effectively alleviate the credit constraints of the household sector, and mitigate household income vulnerability. Secondly, the development of digital credit mitigates household income vulnerability by promoting the breadth and depth of financial services. Thirdly, the heterogeneity analysis shows that the marginal utility of digital credit is higher for the income vulnerability of self-employed households, low-income disadvantaged households, and households in underdeveloped regions. Fourthly, the shock of the COVID-19 pandemic and the implementation of entrepreneurship assistance policies weakened digital credit's alleviation of household income vulnerability.

The Impact of Online Learning during the Covid-19 Pandemic on Academic Outcomes for Newly-Struggling High School Students

The Covid-19 pandemic caused worldwide closures of schools resulting in a sudden shift to online instruction for students. For many students, this shift caused a decrease in academic performance. This study was conducted to explore whether particular demographic variables were associated with decreased academic outcomes for newly-struggling students as well as to determine if there was a relationship between these demographic variables and the frequency of D and F final course grades. Student final course grades were collected from a Midwestern United States high school’s student information system. The data were used to compare academic performance between the fall semester of 2019 during in-person learning and the fall semester of 2020 when the Covid-19 pandemic resulted in school closures and a shift to online learning. Logistic regression analysis was used to answer each of the research questions. The findings from this study suggest that there was a significant relationship between low household income status and status as a newly-struggling student. Additionally this study suggests a significant relationship between low household income status and an increased frequency of D and F final course grades between semesters when compared with sample group peers. Conversely, while special education students did see an increase in frequency of D and F final course grades between semesters it was a significantly lower increase between semesters than their newly-struggling sample group peers.

Urban food (In)security and the role of migrant informal food waste recyclers in Delhi

Urban food systems in developing countries like India are rife with inequalities that preclude food security for all. In this context, the paper examines the role played by informal workers in the ‘circular economy’ for food in improving the accessibility of food and urban food security in Delhi, India. Evidence from an informal street market close to one of the country's largest urban wholesale markets of food grains, pulses and spices in Delhi reveals rare details of how urban food waste plays a significant role in the livelihood strategies of the city's poor migrants while also contributing to the urban food security of the low-income households. Although there is a growing recognition that the street food sector plays an important role in urban food security, the vital role played by waste collectors, home-based workers and street vendors in restoring discarded food grain, pulses and spices, and bringing them back into the urban food system has been largely invisible. This invisibility extends to the gendered segregation of work in food waste recycling, where our study found that predominantly women undertake labour-intensive and lower paid tasks at the bottom of the hierarchy. The paper provides an overview of the nature of informal livelihood, the contribution of informal workers and challenges and opportunities in the urban circular economy for food. However, their contributions are often overshadowed by health and safety concerns about the reuse of discarded food. Further, an analysis of the current policy landscape in urban India also indicates that informal workers are marginalised in the circular economy for food. While the state owes these informal workers support and protection for their contribution to the ‘Circular economy’ for food and urban food security, any effort to sustain these practices would need to incorporate adequate health and safety procedures.

Adherence to glucagon-like peptide-1 receptor agonist treatment in type 2 diabetes mellitus: A nationwide registry study.

To assess the level of adherence to glucagon-like peptide-1 receptor agonist (GLP-1RA) treatment using real-world data and to investigate the sociodemographic and clinical factors associated with discontinuation of GLP-1RAs. First-time users of GLP-1RAs with type 2 diabetes mellitus (T2DM), aged ≥18 years, in the period 2007 to 2020, were identified using Danish registries, allowing all participants a minimum of 18 months' follow-up. Adherence to GLP-1RA therapy (medication possession ratio >0.80) and discontinuation of GLP-1RA therapy was estimated at 6- and 12-month follow-ups. Multivariable cause-specific Cox regression was used to identify sociodemographic and clinical factors associated with risk of discontinuation. In total, 44 343 first-time users of GLP-1RAs with T2DM were identified (mean age 58.6 years, 42.7% female, median duration of T2DM 6.8 years, median glycated haemoglobin level 65 mmol/mol). The absolute risk of discontinuing GLP-1RA treatment within 6 months was 14.2% (95% confidence interval [CI] 13.9-14.6) and 21.2% (95% CI 20.8-21.5) within 12 months. At 6 months, 50.4% were adherent to GLP-1RA therapy and at 12 months, 48.6% remained adherent. In the multivariable model, younger (<40 years) and older age (>75 years), higher Charlson Comorbidity Index score, lower household income, high school and longer university degree as educational attainment level, and longer diabetes duration were associated with a higher risk of discontinuing GLP-1RA treatment. Approximately one in five patients discontinued GLP-1RA therapy within the first 12 months and only half were adherent. Overall, lower socioeconomic status and higher comorbidity burden were associated with higher risk of discontinuing GLP-1RA treatment.

Sociodemographic Factors Related to Perceived Physical Activity on Chilean Adults after COVID-19 Pandemic.

The current study aimed to examine the relationship between sociodemographic variables (i.e., sex, age, marital status, educational level, socioeconomic status, and working mode) and physical activity levels declared by Chilean adults. The sample comprised 483 Chilean adults, 159 men (32.9%) and 324 women (67.1%) aged from 18 to 69 years old (36.5 ± 12.0). The participants completed an ad hoc sociodemographic online survey between December 2022 and March 2023 that included questions about characteristics of participants such as sex, age, educational level, household income, marital status, and working mode. Vigorous, moderate, and walking activities were measured using the International Physical Activity Questionnaire-Short Form (IPAQ-SF), a self-administered questionnaire. Men declared significantly higher vigorous and moderated physical activity than women. People aged 18 to 25, single or unmarried, and with the lowest household income, showed significantly higher scores in vigorous physical activity than those aged 26 to 45, cohabiting with a partner or married, and middle household income, respectively. Regarding working mode, people working at their job site said walking more than people not working, working in a hybrid mode, and working online. Our findings suggest that promoting strategies that increase physical activity during the pandemic is necessary to avoid health problems.

How Early Career Family Medicine Women Physicians Negotiate Their First Job After Residency.

Nested within a growing body of evidence of a gender pay gap in medicine are more alarming recent findings from family medicine: a gender pay gap of 16% can be detected at a very early career stage. This article explores qualitative evidence of women's experiences negotiating for their first job out of residency to ascertain women's engagement with and approach to the negotiation process. We recruited family physicians who graduated residency in 2019 and responded to the American Board of Family Medicine 2022 graduate survey. We developed a semistructured interview guide following a modified life history approach to uncover women's experiences through the transitory stages from residency to workforce. A qualitative researcher used Zoom to interview 19 geographically and racially diverse early career women physicians. Interviews were transcribed verbatim and analyzed using NVivo software following an Inductive Content Analysis approach. Three main themes emerged from the data. First, salary was found to be nonnegotiable, exemplified by participants' inability to change initial salary offers. Second, the role of peer support throughout residency and early career was crucial to uncovering and rectifying salary inequity. Third, a pay expectation gap was identified among women from minority and low-income households. To rectify the gender pay gap in medicine, a systems-level approach is required. This can be achieved through various levels of interventions: societally expanding the use of and removing the stigma around parental leave, recognizing the importance of contributions not currently valued by productivity-based payment models, examining assumptions about leadership; and institutionally moving away from fee-for-service systems, encouraging flexible schedules, increasing salary transparency, and improving advancement transparency.

Weather-related disasters and inflation in the euro area

This article investigates the impact of weather-related disasters on inflation in the euro area over the period 1996–2021. Using a panel structural vector autoregression approach, we explore whether weather-related disasters have a significant and persistent effect on inflation, as well as the role that demand-side and supply-side channels play as drivers of inflation. We also analyse the heterogeneous effects of inflation on different product categories. Our results suggest that weather-related disasters have a positive, non-persistent effect on inflation. This reflects the prevalence of negative supply shock channels and positive demand shock channels over negative demand shock channels. We also find that weather-related disasters have more pronounced effects on the inflation of product categories that represent a higher proportion of the spending of low-income households, implying that disasters reinforce inflation inequality. Overall, our results suggest that, as the climate crisis deepens, it might become increasingly challenging for the European Central Bank to control inflation and its inequality effects.

SNAP Emergency Allotments, Emergency Rent Assistance, Rent Burden, and Housing and Food Security, June 2022-May 2023.

During the COVID-19 pandemic, Supplemental Nutrition Assistance Program (SNAP) emergency allotments and emergency rent assistance provided support to low-income households. Rent burden, a form of housing insecurity, can severely limit household resources, which, in turn, affects health equity. We explored whether these policy interventions equitably supported households that were or were not experiencing rent burden. We used data from the US Household Pulse Survey (June 2022-May 2023) to examine whether associations between emergency support policies and indicators of food and housing security differed according to household rent burden status. We modeled each outcome (food sufficiency or being current on rent) as a function of policy exposure (SNAP emergency allotments or emergency rent assistance), rent burden, and their interaction. We included demographic characteristics, state of residence, and survey cycle as covariates. We modeled each outcome and policy exposure combination separately. Receiving emergency allotments (72.4% vs 67.2% for SNAP participants in states with and without emergency allotments, respectively) and emergency rent assistance (64.5% vs 57.6% for households that received and were waitlisted/denied assistance, respectively) were associated with greater food sufficiency. The relationship between emergency allotments and food sufficiency was stronger in rent-burdened households; however, emergency rent assistance supported food sufficiency to a greater extent in non-rent-burdened households. Emergency rent assistance supported households in being current on rent (78.7% vs 56.4% for households that received and were waitlisted/denied assistance, respectively) and supported being current on rent to a greater extent in non-rent-burdened households than in rent-burdened households. The relationship between emergency support policies and food or housing security differed according to whether households were experiencing rent burden. Associations were sometimes stronger in less economically constrained conditions. These results indicate an opportunity to better design policies to support low-income households, address food and housing security, and ultimately decrease the prevalence of chronic disease.

The COVID-19 Disparities Grant: A Lesson in Radical Place-Based Investment to Overcome COVID-19-Related Health Disparities.

The COVID-19 pandemic highlighted and exacerbated health inequities in New York City (NYC) given the disproportionate risk, morbidity, and mortality related to COVID-19 experienced by communities of color with lower household income. To facilitate long-term community recovery from COVID-19, the NYC Department of Health and Mental Hygiene established the Public Health Corp, a partnership with community-based organizations staffed by community health workers in neighborhoods disproportionately impacted by COVID-19. (Am J Public Health. 2024;114(S7):S566-S569. https://doi.org/10.2105/AJPH.2024.307766).

The Association between Federal Nutrition Assistance Programs and Adolescent Food Security during the COVID-19 Pandemic: Evidence from Baltimore, Maryland.

Given the lack of attention on adolescent food insecurity, the primary objective of this study was to assess the association of household participation in federal food assistance programs with food security status among adolescents in Baltimore during the COVID-19 pandemic. Adolescents, ages 14-19 years, were invited to participate in two online surveys. The baseline was implemented between October 2020 and January 2021, while the follow-up took place one year later from November 2021 to January 2022 after schools had re-opened. We then matched survey participants with household participation in food nutrition assistance programs using data obtained from the Maryland Department of Social Services. We used logistic regression to examine the association between food assistance program participation status and food insecurity. Additionally, to examine whether the impact of program participation on food insecurity changed between the baseline survey and one year later at follow-up when schools re-opened, a difference-in-differences analysis was conducted. The results showed no significant associations between adolescent food security and participation in any of the federal nutrition assistance programs. Increased attention on how best to improve adolescent food security in low-income households that can respond to the unique needs of adolescents is clearly warranted.

Lacking knowledge or lacking support? An informed choice study of support for mileage fees as an alternative to gas taxes

Governing bodies are continuing to research, conduct pilot programs, and adopt policy for mileage fees as alternatives to the gas tax, yet public support remains critically low. Lack of support generally stems from assumptions that mileage fees will cost more, be inequitable for rural and low-income households, and will impede privacy through invasive mileage collection. In this study, we assess the extent to which these perceptions of mileage fees, which ultimately shape policy opinion formation, are related to low levels of information or lacking information. We also evaluate the unique aspects of policy opinion formation, including engagement with both individual and aggregate ideologies and material self-interests. Our survey instrument encourages issue engagement through iterative voting and educational experiences, through which we see information has a statistically significant effect on policy opinions and changes what we think we know about public support for mileage fees. Across the educational experiences, which include policy-relevant information provided through videos and tailored annual cost calculations for the policy alternatives, 24% of respondents changed their opinion by the end of the study, and 44% changed their opinion at least once during the study. We conclude with suggestions for public opinion polling around controversial policies that apply to both researchers and practitioners looking to engage with their constituents.

Inequality and education in Australia

Abstract Australia’s education system is one of the most developed globally and also one of the most privatised. Despite the substantial expenditure by state governments and the federal government, it is profoundly unequal with respect to access, funding, resources, and results from early childhood education to university. The inequality has class and spatial features, and Indigenous Australians are at the bottom of the rung. Drawing on Bourdieu’s concepts of cultural, social, and economic capital, I show that the education system, whilst certainly allowing for some mobility, facilitates the reproduction of the existing class structure. Children from low-income households are more likely to not attend childcare, to attend a school that lacks resources and where going on to university is viewed as exceptional rather than the rule. In contrast, the economic capital of wealthier households allows them to access childcare and elite private schools. The cultural and social capital of these schools reproduces a born to rule ethos, and progression to an elite university is an assumed path.