Moderate-income Individuals Research Articles

Assessing the Financial Literacy of the Blue-Collar Job Workers in terms of Financial Management Practices

The study aimed to assess the financial literacy of blue-collar workers in Valencia City, Philippines, based on their financial management practices. It employed a quantitative approach, using descriptive statistics to analyze data collected from 100 randomly chosen participants. The study found that blue-collar workers in Valencia City showed moderate proficiency in saving, managing expenses and bills, and setting financial goals. They also displayed a fair understanding of financial management principles. However, investment practices were limited due to concerns about scams and distrust, while debt management was rarely practiced due to income fluctuations from hourly wages and project-based work. Despite these challenges, the overall results suggest a moderate financial literacy level of among this group. The study recommends that financial literacy education must be improved. It also encourages companies to provide financial education programs for their employees. And support initiatives that expand access to affordable financial services and promote fair lending practices for low- and moderate-income individuals.

Framing energy-efficiency programs: A survey experiment

In the U.S., many low- and moderate-income households live in energy-inefficient homes and are burdened by energy bills. Although energy-efficiency home improvement programs are long-term solutions for home energy problems, the take-up of income-eligible energy-efficiency programs can be low. This study investigates how information framing affects low- and moderate-income individuals' willingness to participate in energy-efficiency programs in the U.S. as informed by prospect theory and regulatory focus theory. The author used a survey experiment to test how framing free energy-efficiency programs as helping homeowners avoid monetary losses versus framing programs as providing energy savings affects respondents' interest in program participation. Results from a national sample of homeowners pre-stratified by income (N = 1590) suggest that gain-framed messages are more effective in encouraging take-up willingness among moderate-income homeowners than loss-framed messages. At the same time, framing's effect on take-up willingness is statistically insignificant among low-income homeowners. Stress about paying energy bills also predicts willingness to take up energy-efficiency programs with statistical significance. This study contributes to helping policymakers customize information about energy-efficiency programs with different framings for individuals across the income strata.

The Health and Housing Study: Nutrition-Related Outcomes Among Low- to Moderate-Income Individuals Living in or Seeking to Live in New Subsidized Chinatown-Based Housing

Abstract Objectives Housing stability, food security and healthy eating are interrelated. In 2015, a housing lottery for newly developed subsidized housing in Chinatown, Boston, MA was held for low- and moderate- income families who were randomly selected from a waitlist. Four years later (19/20), our study explores the associations between housing status (living in the new subsidized building (NSB) or being on the lottery waitlist) and Food Insecurity (FI); use of food safety net programs (SN), defined as use of SNAP, WIC and/or food pantries; weekly fruit and vegetable consumption (FV); weekly soda consumption; and monthly fast food consumption (FF). Methods Questionnaire links were sent to NSB (n = 95) and waitlist (n = 2498) households. Logistic regression was used to explore the association between housing status and (1) FI (2-item screener) and (2) use of SN (self-reported use in the past year). Linear regression with robust standard error estimation was used to explore the association between housing status and weekly consumption of (1) FV, (2) soda, and (3) monthly consumption of FF, (assessed through health behavior questions from the California Health Interview Survey). Models were adjusted for age, sex, ethnicity, household size, education, income, employment status and distance to grocery store. Results 138 respondents completed the survey; NSB = 36, waitlist = 102. The two housing status groups were demographically similar. Respondents in the NSB showed non-statistically significant lower odds of experiencing FI (OR 0.65, 95% CI [0.3, 1.6]) and of using SN (OR 0.45, 95% CI [0.1, 1.6]). Respondents in the NSB showed non-statistically significant higher weekly consumption of FV (β 2.03, 95% CI [−1.5, 5.6]); lower weekly consumption of soda (β −0.39, 95% CI [−1.9, 1.1]) and lower monthly consumption of FF (β −1.19, 95% CI [−3.9, 1.5]), when compared to respondents on the waitlist. Conclusions In this small sample, main outcomes were not significantly different. Dietary intakes among NSB residents were consistently positive compared to waitlist residents. Future studies should continue to explore mechanisms through which living in a NSB may impact nutrition and health outcomes. Funding Sources Tufts Collaborates Seed Grants. Conclusions do not represent any U.S. Department of Agriculture office or Government determination. This research was not part of MI's work at USDA.

The impact of ACA on medical financial hardship among cancer survivors.

e18160 Background: Prior research has documented that privately insured cancer patients are exposed to significant financial burdens which can result in bankruptcy. A key provision of the Affordable Care Act (ACA) was to set limits on patients out-of-pocket (OOP) spending, which was implemented in 2014. This study aims to assess if OOP limits reduces financial hardship. Methods: Using the 2000-2017 National Health Interview Survey we identified cancer survivors under age 65. We performed a difference in difference analysis which compared financial hardship for low- or moderate-income individuals (LMII), family income under $50,000, to those with higher incomes before and after OOP limits were implemented for privately insured patients. Financial hardship was measured in the following ways: delayed medical care due to cost and the number of family members delayed medical care due to costs, could not afford a prescription, medical care or seeing a specialist, and problems paying medical bills. We used multivariate regression models adjusting for age, race, marital status, gender and size of family. All analyses accounted for the complex survey design and weights. Results: We identified 20,879 privately insured, cancer survivors age 65 or younger. The impact of the ACA resulted in lower financial hardships for LMII compared to higher income persons for most outcomes. The impact of the OOP limits on financial hardship for LMII was seen in any family member delaying care due to costs (difference-in-difference (DiD) = -3.6%; 95% CI = -5.9%, -1.5%; p-value = 0.002), number of family members delaying care due to costs (DiD = -0.048; 95% CI = -0.082, -0.135; p-value = 0.002), had problems paying medical bills (DiD = -3.3%; 95% CI = -6.3%, -0.4%; p-value = 0.028), could not afford prescription medication (DiD = -2.3%; 95% CI = -4.2%, -0.3%; p-value = 0.023), could not afford medical care (DiD = -1.9%; 95% CI = -3.5%, -0.3%; p-value = 0.021), but there was no statistically significant difference in the ability to afford seeing a specialist (DiD = -1.1%; 95% CI = -2.6%, -0.5%; p-value = 0.002). Conclusions: Little research has examined the impact of the ACA’s OOP spending limits. In this study we find that after the introduction of OOP spending limits, financial hardship measured in a variety of ways significantly decreased for LMII.

Income-Based Disparities in Financial Burdens of Medical Spending Under the Affordable Care Act in Families With Individuals Having Chronic Conditions.

This study examined income-based disparities in financial burdens from out-of-pocket (OOP) medical spending among individuals with multiple chronic physical and behavioral conditions, before and after the Affordable Care Act’s (ACA) implementation in 2014. Using the 2012-2015 Medical Expenditure Panel Survey data, we studied changes in financial burdens experienced by nonelderly U.S. populations. Financial burdens were measured by (1) high financial burden, defined as total OOP medical spending exceeding 10% of annual household income; (2) health care cost-sharing ratio, defined as self-paid payments as a percent of total health care payments, excluding individual contributions to premiums; and (3) the total OOP costs spent on health care utilization. The findings indicated reductions in the proportion of those who experienced a high financial burden, as well as reductions in the OOP costs for some individuals. However, individuals with incomes below 138% federal poverty level (FPL) and those with incomes between 251% and 400% FPL who had multiple physical and/or behavioral chronic conditions experienced large increases in high financial burden after the ACA, relative to those with incomes greater than 400% FPL. While the ACA was associated with relieved medical financial burdens for some individuals, the worsening high financial burden for moderate-income individuals with chronic physical and behavioral conditions is a concern. Policymakers should revisit the cost subsidies for these individuals, with a particular focus on those with chronic conditions.

Collaborating for Community Health.

The Greensboro Housing Coalition was founded 27 years ago to advocate for fair, safe, decent, and affordable housing for low- to moderate-income individuals. We advocate in 4 primary service areas: foreclosure prevention/homeowner counseling, homelessness prevention/ rental housing counseling, healthy homes, and our Community Centered Health Initiative.

Savings Program Participation and Outcomes for Hispanics

ABSTRACTLow- and moderate-income Hispanics in the United States have traditionally experienced few institutional incentives for savings and asset development and have instead encountered many disincentives. The authors provide a brief review of the various enticements and deterrents for savings and wealth development for traditionally underrepresented groups, with a focus on Hispanics. One of the most recent savings initiatives for low- and moderate-income individuals involves dedicated savings accounts, also known as Individual Development Accounts (IDAs). This study was designed to examine whether IDA program completion supports asset development over time for Hispanics. Results indicate that while there are no statistically significant differences in asset growth between IDA completers and non-completers, IDA program completers did experience more growth on all asset measures. The authors provide suggestions on how to close the racial and ethnic wealth gap for low- and moderate-income Hispanic individuals and households.

Update on the Affordable Care Act. King v. Burwell and Obergefell v. Hodge.

Patients with respiratory diseases, critical illness, or sleep disorders who lack health insurance endure disparities in access to care and worse health outcomes. These disparities were partly addressed in the United States in 2010 by passage of the Affordable Care Act. Low- and moderate-income individuals and families with incomes between 138 and 400% of the federal poverty level are eligible for insurance premium subsidies when purchasing policies on the health insurance marketplace exchanges. Since the act was passed, nearly 16.5 million Americans have gained health insurance. In 2015, the act survived what may be the last significant judicial challenge to the law: King v. Burwell. The plaintiffs challenged whether people who purchased health insurance in states that use the federal insurance marketplace HealthCare.gov , rather than a state-run marketplace, were eligible to receive insurance premium subsidies. At the time of the ruling, 34 states used the federal exchange, and as a result, nearly 7.5 million people could have lost their health insurance if the court had ruled in favor of the plaintiffs. However, in King v. Burwell, the Court ruled six to three in support of the legality of subsidies regardless of type of marketplace states use, thereby ensuring continued health insurance coverage for patients in states using the federal marketplace exchange. In 2015, the Supreme Court also heard a landmark case, Obergefell v. Hodge, in which the Court upheld the right for two people of the same sex to marry, thereby opening crucial access to both state and federal benefits and protections for same-sex couples.

Lay Deployment of Professional Legal Knowledge

We will never have enough lawyers to serve the civil legal needs of all low- and moderate-income (LMI) individuals who must navigate civil legal problems. A significant part of the access to justice toolkit must include self-help materials. That much is not new; indeed, access to justice commissions across the country have been actively developing pro se guides and forms for decades. But the community has hamstrung its creations in two major ways. First, by focusing these materials on educating LMI individuals about formal law, and second, by considering the task complete once the materials are available to self-represented individuals. In particular, modern self-help materials fail to address many psychological and cognitive barriers that prevent LMI individuals from successfully deploying their contents. This Article makes two contributions. First, we develop a theory of the obstacles LMI individuals face when attempting to deploy professional legal knowledge. Second, we apply learning from fields as varied as psychology, public health, education, artificial intelligence, and marketing to develop a framework for how courts, legal aid organizations, law school clinics, and others might re-conceptualize the design and delivery of civil legal materials for unrepresented individuals. We illustrate our framework with examples of reimagined civil legal materials.

Service-Seeking Behavior, Perceptions of Armed Actors, and Preferences Regarding Governance: Evidence from the Palestinian Territories

Armed non-state actors, such as Hezbollah and Hamas, are visibly engaged in providing social welfare in addition to participating in violence. A number of scholars have suggested that there is a relationship between service provision by terrorist organizations and support from service recipients, and have indicated that terrorist organizations use service provision strategically for this purpose. However, few studies have examined the experiences and opinions of service recipients themselves to understand if services do indeed influence populations' political loyalties and opinions regarding violent activities. Using data from more than 1,000 low to moderate income individuals in Palestine, this study seeks to understand if and how receiving services from a specific organization engenders loyalty to the organization, passive acceptance and/or favorable approval of the organizations' violent activities, and the likelihood of participation in the organization's violent activities. This paper explores if and how provision of aid and “governance” services by armed non-state actors is correlated with various aspects of individuals' experiences of conflict, such as their opinions about the use of violence and various strategies for attaining peace, their fellow community members' likelihood to join armed groups and engage in fighting, and their preferences regarding state structure and legal system.

The Affordable Care Act: a primer for plastic surgeons.

The Patient Protection and Affordable Care Act, sometimes referred to as Obamacare, was signed into law on March 23, 2010. It represents the most extensive overhaul of the country's health care system since the passage of Medicare and Medicaid in 1965. The Affordable Care Act has two goals. The first goal is to reduce the uninsured population in the United States. Key elements to covering the uninsured include the following: (1) expanding Medicaid coverage for low-income individuals and (2) establishing health insurance marketplaces for moderate-income individuals with subsidies and tax cuts in an effort to make health insurance more affordable. The second goal of the Affordable Care Act is to address concerns about quality and the overall cost of U.S. health care. It is imperative that plastic surgeons thoroughly understand the impact that the Affordable Care Act will undoubtedly have on the country, on our patients, and on our clinical practices. Plastic surgery will see many changes in the future. This will include an overall increase in the number of insured patients, a push toward joining accountable care organizations, and a shift in payment systems to bundled reimbursement for episodes of care. In this article, the authors describe how these changes are likely to occur and what plastic surgeons must do to be part of the change.

Encouraging Low- and Moderate-Income Tax Filers to Save: Implementation and Interim Impact Findings from the SaveUSA Evaluation

SaveUSA, a voluntary program launched in 2011 in four cities (New York City, Tulsa, San Antonio, and Newark), encourages low- and moderate-income individuals to set aside money from their tax refund for savings. Tax filers at participating Volunteer Income Tax Assistance (VITA) sites can directly deposit all or a portion of their tax refund into a special savings account, set up by a bank or credit union, and pledge to save between $200 and $1,000 of their deposit for about a year. Money can be withdrawn from SaveUSA accounts at any time and for any purpose, but only those who maintain their initially pledged savings amount throughout a full year receive a 50 percent match on that amount. Account holders, irrespective of match receipt, can deposit tax refund dollars in subsequent years and become eligible to receive additional savings matches on their new tax refund deposits.This report presents findings on SaveUSA’s implementation in all four cities and its early effects on savings and other financial outcomes in two cities: New York City and Tulsa. In these latter cities, a randomly selected half of the tax filers who were interested in SaveUSA in 2011 could open accounts (the “SaveUSA group”), but the other half could not (the control group). The report compares the savings and other financial behaviors of the two groups over time to estimate SaveUSA’s effects. The findings thus suggest the effects that savings policies structured similarly to SaveUSA might have.SaveUSA’s operation and evaluation are funded through the federal Social Innovation Fund (SIF), a public/private partnership administered by the Corporation for National and Community Service. This particular SIF project is led by the Mayor’s Fund to Advance New York City and the NYC Center for Economic Opportunity (CEO) in collaboration with MDRC. Matching funds required by the SIF were provided by several foundations and organizations. CEO, with the New York City Department of Consumer Affairs Office of Financial Empowerment (OFE), which conceived and launched an early version of the model, leads SaveUSA operations; MDRC is conducting the program’s evaluation.Key Findings: SaveUSA was implemented successfully in all four cities. During the first program year, individuals in the SaveUSA group directly deposited an average of $506 of their tax refunds into SaveUSA accounts.About two-thirds of those in the SaveUSA group saved for about a year and received a first savings match, which averaged $291 among those who received it. About two-fifths of the SaveUSA group pledged to save part of their tax refund again in the program’s second year.At the 18-month follow-up point, SaveUSA had increased the percentage of individuals with any short-term savings (by 7 percentage points) and increased the total amount of savings individuals held on average (by $512), compared with what they would have saved without the program. The program also had increased the proportion of those who expressed a continued commitment to save.No effects were found on individuals’ amount of debt, material hardship, or other aspects of financial security over the 18-month follow-up period.A subsequent report in late 2015 will examine SaveUSA’s effects over 36 to 42 months and will present a much more complete assessment of whether SaveUSA can sustain savings and improve individuals’ overall financial well-being.

Economic Benefits of Asset Building: Is Homeownership the Best Strategy for Rural Low-Income Households?

This study uses data from action research among low- to moderate-income individuals in a rural Mississippi county to assess the economic benefits of building assets through homeownership. The study assesses various financial practices among homeowners and renters such as savings and borrowing behavior as well as money management. The results indicate that being an owner, compared to a renter, may lead to better saving and borrowing behavior. However, both groups responded somewhat similarly regarding general savings, some debt (for example, payday loans and consumer credit), and money management (for example, knowing what percent of income is spent on specific expenses). The findings imply that promoting homeownership as a viable means for asset building among this sample should be done cautiously and that programmatic efforts for asset building may benefit from including small business development and/or educational attainment.

CHOOSING HOME FOR SOMEONE ELSE: GUARDIAN RESIDENTIAL DECISION-MAKING

Few things are as important as where you live, where you call home. “Home is where the heart is.” “There is no place like home.” Home can be place where one has “deep-seated ties with family members and close friends” and “a harbor of family traditions.” For a frail, older person or an individual with disabilities, “home” can be a long-standing family residence, but might also be a room in assisted living, a nursing home, group home, or other option where support and services can be provided. Where you live conjures up fundamental values of independence, safety, comfort, and community engagement. A guardian with responsibility for determining where a person with diminished capacity will live takes on a charge that goes to the core of quality of life. Of course, a guardian’s “choice” of where a person will live is set in a constellation of factors that bear on or even dictate the outcome—the person’s expressed preferences, the availability of optimal settings, the financial resources available, the risk involved, the kinds of care and supervision needed, the applicable law and court order, the process of hospital discharge planning, and more. The guardian’s residential decision is set against a backdrop of federal and state long-term care policy. Without available and affordable options, a guardian will be in a bind. The extent to which these settings are readily available is influenced by federal and state priorities and budgets for institutional versus community-based care. The recent recession has put a crimp in available options, especially for low- and moderate-income individuals—which squeezes guardians into making that daunting determination of where “home” will be. By making surrogate residential decisions and providing consent for transitions from one setting to another, guardians are a key piece in the puzzle for policy-makers in designing a workable system for long-term supports and services, and in facilitating the drive toward community-based options.

Encouraging Savings for Low- and Moderate-Income Individuals: Preliminary Implementation Findings from the SaveUSA Evaluation

SaveUSA, a pilot program in New York City, Newark, San Antonio, and Tulsa, offers a matched savings account to low-income tax filers, building on the opportunity presented by tax-time refunds, especially the Earned Income Tax Credit. This 12-page brief offers early implementation findings.

Medical-Legal Partnerships: Addressing Competency Needs Through Lawyers

Many low- and moderate-income individuals and families have at least one unmet legal need (for example, unsafe housing conditions, lack of access to food and/or income support, lack of access to health care), which, if left unaddressed, can have harmful consequences on health. Eighty unique medical-legal partnership programs, serving over 180 clinics and hospitals nationwide, seek to combine the strengths of medical and legal professionals to address patients' legal needs before they become crises. Each partnership is adapted to serve the specific needs of its own patient base. This article describes innovative, residency-based medical-legal partnership educational experiences in pediatrics, internal medicine, and family medicine at 3 different sites (Boston, Massachusetts; Newark, New Jersey; and Tucson, Arizona). This article addresses how these 3 programs have been designed to meet the Accreditation Council for Graduate Medical Education's 6 competencies, along with suggested methods for evaluating the effectiveness of these programs. Training is a core component of medical-legal partnership, and most medical-legal partnerships have developed curricula for resident education in a variety of formats, including noon conferences, grand rounds, poverty simulations and day-long special sessions. Medical-legal partnerships combine the skill sets of medical professionals and lawyers to teach social determinants of health by training residents and attending physicians to identify and help address unmet legal needs. Medical-legal partnership doctors and lawyers treat health disparities and improve patient health and well-being by ensuring that public programs, regulations, and laws created to benefit health and improve access to health care are implemented and enforced.

Relationships Between Assets and Perceived Economic Strain

Income and wealth disparity continue to widen among U.S. households. Efforts to combat poverty generally consist of income-based policies while wealth creation involves asset-based policies. Asset theory suggests that an asset-based approach to poverty reduction will help increase the personal, social, and economic well-being of low-income households. As a result, Individual Development Accounts (IDAs), or dedicated savings accounts, were designed to help propel low- and moderate-income individuals out of poverty by building assets in the form of home ownership, small business development, and post-secondary education. One way in which IDAs are hypothesized to increase well-being is by improving household economic stability. This longitudinal study examined the relationships between asset building and perceived economic strain. Findings support the notion that IDAs are positively associated with perceptions of economic stability among households. In other words, it may be that assets help increase economic resources and well-being among low-income households.

Regulatory Incentives and Consolidation: The Case of Commercial Bank Mergers and the Community Reinvestment Act

Abstract Bank regulators are required to consider a bank’s record of providing credit to low- and moderate-income neighborhoods and individuals in approving bank applications for mergers and acquisitions. We provide evidence that banks self-regulate by strategically increasing their lending to these populations prior to acquiring another institution in anticipation of the regulatory and public scrutiny associated with a merger or acquisition. In particular, we show that the higher the percentage of the institution’s mortgage originations in a given year that are directed to low- and moderate-income individuals or neighborhoods, the greater the probability that the institution will acquire another bank in the following year. Further investigation bolsters the view that this correlation is due to banks’ anticipation of the public and regulatory scrutiny during the merger review process: (1) the effect cannot be explained by regulator behavior or by unobserved bank characteristics; (2) the relationship is observed for acquiring banks, which are the primary focus of scrutiny, but not for the banks that are being acquired; (3) the positive effect increases over the 1991 to 1995 time frame, a period when scrutiny of an institution’s community lending record increased; and (4) the effect is largest for big banks, who face particularly intense scrutiny.

Regulatory Incentives and Consolidation: The Case of Commercial Bank Mergers and the Community Reinvestment Act

Bank regulators are required to consider a bank’s record of providing credit to low- and moderate-income neighborhoods and individuals in approving bank applications for mergers and acquisitions. We test the hypothesis that banks strategically prepare for the regulatory and public scrutiny associated with a merger or acquisition by increasing their lending to low-and moderate-income individuals in anticipation of acquiring another institution. We find evidence in favor of this hypothesis. In particular, we show that the higher the percentage of the institution’s mortgage originations in a given year that are directed to low- and moderate-income individuals or neighborhoods, the greater the probability that the institution will acquire another bank in the following year. Further investigation bolsters the view that this correlation is due to banks’ anticipation of the public and regulatory scrutiny during the merger review process. The effect cannot be explained by other bank characteristics. The relationship is observed for acquiring banks, which are the focus of public and regulatory scrutiny, but not for the banks that are being acquired. In addition, the positive effect of lending to low- and moderate-income individuals and neighborhoods on the likelihood that a bank will acquire another bank increases over the 1991 - 1995 time frame, a period when public and regulatory scrutiny of an institution’s community lending record increased. The effect of lending to low- and moderate-income individuals and neighborhoods is also largest for big banks, who face particularly intense public and regulatory scrutiny

Regulatory Incentives and Consolidation: The Case of Commercial Bank Mergers and the Community Reinvestment Act

Bank regulators are required to consider a bank's record of providing credit to low- and moderate-income neighborhoods and individuals in approving bank applications for mergers and acquisitions. We test the hypothesis that banks strategically prepare for the regulatory and public scrutiny associated with a merger or acquisition by increasing their lending to low- and moderate-income individuals in anticipation of acquiring another institution. We find evidence in favor of this hypothesis. In particular, we show that the higher the percentage of the institution's mortgage originations in a given year that are directed to low- and moderate-income individuals or neighborhoods, the greater the probability that the institution will acquire another bank in the following year. Further investigation bolsters the view that this correlation is due to banks' anticipation of the public and regulatory scrutiny during the merger review process. The effect cannot be explained by other bank characteristics. The relationship is observed for acquiring banks, which are the focus of public and regulatory scrutiny, but not for the banks that are being acquired. In addition, the positive effect of lending to low- and moderate-income individuals and neighborhoods on the likelihood that a bank will acquire another bank increases over the 1991 - 1995 time frame, a period when public and regulatory scrutiny of an institution's community lending record increased. The effect of lending to low- and moderate-income individuals and neighborhoods is also largest for big banks, who face particularly intense public and regulatory scrutiny.