Impacting Entry into Evidence-Based Supported Employment: A Population-Based Empirical Analysis of a Statewide Public Mental Health Program in Maryland by David S. Salkever, Michael Abrams, Kevin Baier, Brent Gibbons :: SSRN

February 10, 2017

Access to evidence-based supported employment (SE) services for persons with serious mental illness is limited in the U.S., despite evidence such services are effective and could benefit more persons. Major barriers to SE expansion are overlapping and limited funding streams, and interagency coordination problems. An important recent initiative in one state (Maryland) addressed both types of barriers. This longitudinal analysis of SE take-up probabilities for population-based cohorts of Medicaid recipients, during 2002-2010, provided tentative evidence of initiative impacts (particularly during the recession downturn), and evidence of effects for a schizophrenia diagnosis, prior work-history, health and demographic characteristics, and geographic accessibility.

Source: Impacting Entry into Evidence-Based Supported Employment: A Population-Based Empirical Analysis of a Statewide Public Mental Health Program in Maryland by David S. Salkever, Michael Abrams, Kevin Baier, Brent Gibbons :: SSRN


Social Assistance and Minimum Income Levels and Replacement Rates Dataset by Jinxian Wang, Olaf van Vliet :: SSRN

February 9, 2017

The Social Assistance and Minimum Income Levels and Replacement Rates Dataset provides two new indicators for comparisons of social assistance and minimum income benefits across countries and over time, namely real net minimum income benefit levels and net minimum income benefit replacement rates. The dataset contains information for 33 countries for the period 1990–2009. For information on social assistance and minimum income benefits, the dataset draws upon information from Nelson’s (2013) dataset. The minimum income replacement rates are comparable to unemployment replacement rates.

Source: Social Assistance and Minimum Income Levels and Replacement Rates Dataset by Jinxian Wang, Olaf van Vliet :: SSRN


The Happiest States in 2016: Full List

February 4, 2017

A new poll from Gallup-Healthways shows which states had the highest and lowest well-being in 2016. Well-being scores are based on participants’ answers to questions about their sense of purpose, social relationships, financial lives, community involvement and physical health.

Source: The Happiest States in 2016: Full List


Reproductive Justice & Preventable Deaths: State Funding, Family Planning, Abortion, and Infant Mortality, US 1980–2010 by Nancy Krieger, Sofia Gruskin, Nakul Singh, Mathew Kiang, Jarvis Chen, Pamela Waterman, Jason Beckfield, Brent Coull :: SSRN

January 23, 2017

Introduction: Little current research examines associations between infant mortality and US states’ funding for family planning services and for abortion, despite growing efforts to restrict reproductive rights and services and documented associations between unintended pregnancy and infant mortality.

Material and methods: We obtained publicly available data on state-only public funding for family planning and abortion services (years available: 1980, 1987, 1994, 2001, 2006, and 2010) and corresponding annual data on US county infant death rates. We modeled the funding as both fraction of state expenditures and per capita spending (per woman, age 15–44). State-level covariates comprised: Title X and Medicaid per capita funding, fertility rate, and percent of counties with no abortion services; countylevel covariates were: median family income, and percent: black infants, adults without a high school education, urban, and female labor force participation. We used Possion log-linear models for: (1) repeat cross-sectional analyses, with random state and county effects; and (2) panel analysis, with fixed state effects.

Results: Four findings were robust to analytic approach. First, since 2000, the rate ratio for infant death comparing states in the top funding quartile vs. no funding for abortion services ranged (in models including all covariates) between 0.94 and 0.98 (95% confidence intervals excluding 1, except for the 2001 cross-sectional analysis, whose upper bound equaled 1), yielding an average 15% reduction in risk (range: 8–22%). Second, a similar risk reduction for state per capita funding for family planning services occurred in 1994. Third, the excess risk associated with lower county income increased over time, and fourth, remained persistently high for counties with a high percent of black infants.

Conclusions: Insofar as reducing infant mortality is a government priority, our data underscore the need, despite heightened contention, for adequate public funding for abortion services and for redressing health inequities.

Source: Reproductive Justice & Preventable Deaths: State Funding, Family Planning, Abortion, and Infant Mortality, US 1980–2010 by Nancy Krieger, Sofia Gruskin, Nakul Singh, Mathew Kiang, Jarvis Chen, Pamela Waterman, Jason Beckfield, Brent Coull :: SSRN


Reforming Federal Powers to Control Emerging Infectious Conditions: CDC’s Regulatory Proposals by James G. Hodge, Sarah Wetter, Danielle Chronister, Sarah Noe :: SSRN

January 21, 2017

On August 15, 2016, CDC shared for initial public comment newly proposed regulations to clarify its powers pursuant to the Public Health Service Act (PHSA). These regulatory powers, reserved largely for public health exigencies, explain CDC’s authority to assess, apprehend, quarantine, test, examine, isolate, and monitor ill individuals with potentially infectious conditions arriving or traveling in the U.S.

CDC is attempting to strengthen its national public health powers amidst expanding infectious disease threats, particularly among foreign and interstate travelers, within a federalist structure traditionally dominated by state, territorial, tribal, and local public health efforts. Modernizing federal social distancing powers may be beneficial especially for health providers (and their legal counsels) responsible for screening and treating suspect patients. Yet CDC’s draft regulations raise numerous legal and policy concerns that could limit their utility.

This article examines the need for revamped federal powers in a globalized society rife with disease risks as a backdrop to CDC’s proposed regulations in response. Public health support for CDC’s role is explored coextensively with potential constitutional and other legal pitfalls that may derail execution of the regulations absent final changes.

Source: Reforming Federal Powers to Control Emerging Infectious Conditions: CDC’s Regulatory Proposals by James G. Hodge, Sarah Wetter, Danielle Chronister, Sarah Noe :: SSRN


Saving and Wealth Inequality by Mariacristina De Nardi, Giulio Fella :: SSRN

January 21, 2017

Why are some people rich while others are poor? To what extent can governments affect inequality? Which instruments should they use? Answering these questions requires understanding why people save. Dynamic quantitative models of wealth inequality can help us understand and quantify the determinants of the outcomes that we observe in the data and to evaluate the consequences of policy reform. This paper surveys the savings mechanisms generated by the transmission of bequests and human capital, by preference heterogeneity, by rates of returns heterogeneity, by entrepreneurship, by richer earnings processes, and by medical expenses. It concludes that the transmission of bequests and human capital, entrepreneurship, and medical expense risk are crucial determinants of savings and wealth inequality.

Source: Saving and Wealth Inequality by Mariacristina De Nardi, Giulio Fella :: SSRN


Medicaid Managed Care and Medical Homes – AAF

December 13, 2016

Medicaid is a program in great need of reducing costs and improving outcomes for its beneficiaries. Medicaid managed care programs can assist in accomplishing both of these goals. Medical homes, developed in conjunction with managed care programs, can provide even greater benefit, particularly for those patients with the greatest needs, such as children, the aged and the disabled. Medical homes provide for enhanced coordination of care, with particular consideration given to each patient’s (and their families’) desires and limitations. Medicaid managed care programs working in conjunction with medical homes could provide significant benefits to patients, as well as federal and state budgets. Quality metrics and evidence-based standards of care designed specifically for children and patients with chronic needs should be developed.

Source: Medicaid Managed Care and Medical Homes – AAF