Targeting, universalism, and single-mother poverty: a multilevel analysis across 18 affluent democracies

The Effect of Welfare State Policy Spending on the Equalization of Socioeconomic Status Disparities in Mental Health

This article examines whether and how the relationship between socioeconomic status (SES) and depression is modified by welfare state spending using the 2006, 2012, and 2014 survey rounds of the European Social Survey (ESS) merged with macroeconomic data from the World Bank, Eurostat, and SOCX database (N = 87,466). Welfare state spending effort divided between social investment and social protection spending modifies the classic inverse relationship between SES and depression. Distinguishing policy areas in both social investment and social protection spending demonstrates that policy programs devoted to education, early childhood education and care, active labor market policies, old age care, and incapacity account for differences in the effect of SES across countries. Our analysis finds that social investment policies better explain cross-national differences in the effect of SES on depression, implying policies focused earlier in the life course matter more for understanding social disparities in the mental health of populations.

Poverty, not the poor

This review explains how and why the United States has systemically high poverty. Descriptive evidence shows that U.S. poverty is (i) a huge share of the population, (ii) a perennial outlier among rich democracies, (iii) staggeringly high for certain groups, (iv) unexpectedly high for those who "play by the rules," and (v) pervasive across various groups and places. This review then discusses and critiques three prevailing approaches focused on the individual poor rather than the systemically high poverty: (i) behavioral explanations "fixing the poor," (ii) emotive compassion "dramatizing the poor," and (iii) cultural explanations both dramatizing and fixing the poor. The essay then reviews political explanations that emphasize the essential role of social policy generosity, political choices to penalize risks, power resources of collective political actors, and institutions. This review demonstrates a long emerging but ascending and warranted shift away from individualistic explanations of the poor toward political explanations of poverty.

Targeted Approaches, Universalism, and Targeted Universalism: Opportunities for the U.S. Correctional Health Care System

Social policy has traditionally been implemented in two ways: using targeted or universal approaches. Each of these mechanisms has advantages and disadvantages to the populations to whom the policies are applied and to the system applying the policies. A third approach to social policy implementation has emerged: targeted universalism. Targeted universalism is not simply a combination of targeted and universal approaches. It stands apart as a unique way of conceptualizing and implementing social policy. This viewpoint provides an overview of targeted approaches, universalism, and targeted universalism to social policy development and implementation. It examines the ways targeted universalism could be applied to the U.S. correctional health care system to ensure that people who are incarcerated receive the health care to which they are constitutionally entitled.

Influence of Parenting Guilt on the Mental Health among Single-Parent Women: Multiple Additive Moderating Effect of Economic Well-Being and Level of Education

This study explored how the core problems (e.g., parenting, economy, and education level) of single-parent women affect their mental health. Although parenting guilt, economic well-being, and level of education are important variables that affect the mental health of single parents, there is no study that examines the interaction effect between them together. Therefore, this study examined the moderating effects of economic well-being and level of education on the relationship between parenting guilt and mental health in 419 single-parent women. In addition, it was verified whether there was a multiple additive modulation effect when they were put in at the same time. As a result, the higher the parenting guilt and the lower the economic well-being, the higher the level of mental health pain, but the level of education had no statistical significance. However, the interaction term between parenting guilt and education level had statistical significance, while the interaction term between parenting guilt and economic well-being did not produce significant results. These findings suggest the importance of education for single-parent women's mental health as well as the need to establish policies that allow them to have sufficient time and room for child rearing.

Double Disadvantage in a Nordic Welfare State: A Demographic Analysis of the Single-Parent Employment Gap in Finland, 1987-2018

This study demonstrates how an evolving negative educational gradient of single parenthood can interact with changing labour market conditions to shape labour market inequalities between partnered and single parents. We analysed trends in employment rates among Finnish partnered and single mothers and fathers from 1987 to 2018. In the late 1980s' Finland, single mothers' employment was internationally high and on par with that of partnered mothers, and single fathers' employment rate was just below that of partnered fathers. The gaps between single and partnered parents emerged and increased during the 1990s recession, and after the 2008 economic crisis, it widened further. In 2018, the employment rates of single parents were 11-12 percentage points lower than those of partnered parents. We ask how much of this single-parent employment gap could be explained by compositional factors, and the widening educational gradient of single parenthood in particular. We use Chevan and Sutherland's decomposition technique on register data, which allows us to decompose the single-parent employment gap into the composition and rate effects by each category of the background variables. The findings point to an increasing double disadvantage of single parents: the gradually evolving disadvantage in educational backgrounds together with large differences in employment rates between single and partnered parents with low education explain large parts of the widening employment gap. Sociodemographic changes in interaction with changes in the labour market can produce inequalities by family structure in a Nordic society known for its extensive support for combining childcare and employment for all parents.

Income Sources Across Childhood in Families With Nonresident Fathers

Unpartnered mothers rely on formal and informal income sources to support their coresident minor children. Building on work focusing on selective populations and shorter time horizons, we describe the family income sources on which U.S. women and their minor children rely for up to 17 years following an unpartnered birth or union dissolution (Panel Study of Income Dynamics 2001-2017; N = 12,369 person-year records from 3,148 children). Using rich description and fixed-effect models, we treat family income as dynamic, mapping change in the share and amount of family income from multiple sources as children age and women gain employment experience; enter new unions; experience changes in eligibility for public support programs; and receive contributions from kin, friends, and other household members. A patchwork of income sources is the norm throughout childhood, with mothers' earnings nearly universal but insufficient as a sole source of family income. Maternal repartnering increases family income through new partner earnings but is accompanied by offsetting reductions in other income sources, particularly from outside the household. In the context of weak institutional support for U.S. families, families with nonresident fathers rely on a complex mix of income sources to make ends meet.

A Critical Analysis of Dobbs v. Jackson Women's Health Organization and the Consequences of Fetal Personhood

In this paper, I will examine the Supreme Court of the United States' (SCOTUS) arguments in the majority decision in Dobbs v. Jackson Women's Health Organization, and I will show how some of those arguments are flawed. Primarily, I will show that the right to bodily autonomy is a well-established right, both in the courts and in societal practices, and that the right to an abortion should be understood as an example of the right to bodily autonomy or bodily integrity. Second, I will examine the justices' arguments that viability is not a reasonable place to restrict abortion access, in contrast to both Roe v. Wade and Planned Parenthood v. Casey, and will offer arguments that defend viability as a valid point to limit abortion access. Third, I will highlight some politicians' goals to enact a federal ban on abortion, and show how the attempt to pass Personhood Amendments is a pathway for doing so. The upshot of this essay to is show how the SCOTUS decision is flawed, and how granting personhood to "potential life" has consequences that extend beyond abortion access.

Does Part-Time Mothering Help Get a Job? The Role of Shared Custody in Women's Employment

Though child shared physical custody arrangements after divorce are much more frequent and parents who use it more diverse in many European countries, little is known about their economic consequences for parents. By relaxing family time constraints, does shared custody help divorced mothers return to or stay on work more easily? Since lone mothers are one of the least-employed groups, and they face high unemployment rates, the type of child custody arrangement adopted after divorce is of particular interest for their employability. This article analyses to what extent the type of child custody arrangement affects mothers' labour market patterns after divorce.Using a large sample of divorcees from an exhaustive French administrative income tax database, and taking advantage of the huge territorial discrepancies observed in the proportion of shared custody, we correct for the possible endogeneity of shared custody. Results show that not repartnered mothers with shared custody arrangements are 24 percentage points more likely to work one year after divorce compared to those having sole custody, while no significant effect is found for repartnered mothers. Among lone mothers, we also highlight huge heterogeneous effects: larger positive effects are observed for previously inactive women, for those belonging to the lowest income quintiles before divorce, for those with a young child, and for those who have three or more children. Thus, shared physical custody arrangements may reduce work-family conflict by diminishing childcare expenses and enlarge the possibilities to find a suitable job because of more relaxed time constraints for lone mothers.

Socioeconomic disadvantages and vulnerability to the pandemic among children and youth: A macro-level investigation of American counties

This study intends to reveal the underlying structural inequity in vulnerability to infection of the novel coronavirus disease pandemic among children and youth. Using multi-source data from New York Times novel coronavirus disease tracking project and County Health Rankings & Roadmap Program, this study shows that children and youth in socioeconomically disadvantaged status are faced with disproportionate risk of infection in this pandemic. On the county level, socioeconomic disadvantages (i.e., single parent family, low birthweight, severe housing problems) contribute to the confirmed cases and death cases of the novel coronavirus disease. Policymakers should pay more attention to this vulnerable group to implement more targeted and effective epidemic prevention and control.

Public Investments and Class Gaps in Parents' Developmental Expenditures

Families and governments are the primary sources of investment in children, providing access to basic resources and other developmental opportunities. Recent research identifies significant class gaps in parental investments that contribute to high levels of inequality by family income and education. State-level public investments in children and families have the potential to reduce class inequality in children's developmental environments by affecting parents' behavior. Using newly assembled administrative data from 1998-2014, linked to household-level data from the Consumer Expenditure Survey, we examine how public sector investment in income support, health and education is associated with the private expenditures of low and high-SES parents on developmental items for children. Are class gaps in parental investments in children narrower in contexts of higher public investment for children and families? We find that more generous public spending for children and families is associated with significantly narrower class gaps in private parental investments. Moreover, we find that equalization is driven by bottom up increases in low-SES households' developmental spending in response to the progressive state investments of income support and health, and by top down decreases in high-SES households' developmental spending in response to the universal state investment of public education.

Do taxes and transfers reduce gender income inequality? Evidence from eight European welfare states

We examine how taxes and transfers affect the incomes of men and women. Using microsimulation and intra-household income splitting rules, we measure the differences in the level and composition of individual disposable income by gender in eight European countries covering various welfare regime types. We quantify the extent to which taxes and transfers can counterbalance the gender gap in earnings, as well as which policy instruments contribute most to reducing the gender income gap. We find that with the exception of old-age public pensions, all taxes and transfers significantly reduce gender income inequality but cannot compensate for high gender earnings gaps. Our findings suggest that gender income equality is more likely to be achieved by promoting the universal/dual breadwinner model, whereby women's labour force participation and wages are on a par with men. To achieve this, men will likely need to work less and care more.

Contraceptive Consistency and Poverty after Birth

Unplanned pregnancies in the U.S. disproportionately occur among poor, less educated, and minority women, but it is unclear whether poverty following a birth is itself an outcome of this pregnancy planning status. Using the National Longitudinal Survey of Youth 1997 (n=2,101) and National Survey of Family Growth (n=778), we constructed two-year sequences of contraceptive use before a birth that signal an unplanned versus a planned birth. We regressed poverty in the year of the birth both on this contraceptive-sequence variable and on sociodemographic indicators including previous employment and poverty status in the year before the birth, race/ethnicity, education, partnership status, birth order, and family background. Compared to sequences indicating a planned birth, sequences of inconsistent use and non-use of contraception were associated with a higher likelihood of poverty following a birth, both before and after controlling for sociodemographic variables, and before and after additionally controlling for poverty status before the birth. In pooled-survey estimates with all controls included, having not used contraception consistently is associated with a 42% higher odds of poverty after birth. The positive association of poverty after birth with contraceptive inconsistency or non-use, however, is limited to women with low to medium educational attainment. These findings encourage further exploration into relationships between contraceptive access and behavior and subsequent adverse outcomes for the mother and her children.

Socio-Economic Differences in the Prevalence of Single Motherhood in North America and Europe

The study focuses on understanding the association between parental socio-economic status (SES) and the likelihood of women experiencing a first birth while single, and identifying societal factors that influence this association in 18 North American and European societies. Previous research has shown that single motherhood occurs disproportionately among those from with lower a lower parental SES. The study assesses whether this is caused by parental SES differences in the risk of single women experiencing a first conception leading to a live birth or by parental SES differences in how likely women are to enter a union during pregnancy. Additionally, an assessment is made of whether cross-national differences in these associations can be explained by a country's access to family planning, norms regarding family formation, and economic inequality. Across countries, a negative gradient of parental SES was found on the likelihood of single women to experience a first pregnancy. The negative gradient was stronger in countries with better access to family planning. In some countries, the negative gradient of parental SES was aggravated during pregnancy because women from lower parental SES were less likely to enter a union. This was mostly found in societies with less conservative norms regarding marriage. The results suggest that certain developments in Western societies may increase socio-economic differentials in family demography.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10680-021-09591-3.

[Theoretical and practical challenges of proportionate universalism: a reviewAnálise dos desafios teóricos e práticos de universalismo proporcional]

OBJECTIVE

In 2010, the principle of proportionate universalism (PU) has been proposed as a solution to reduce health inequalities. It had a great resonance but does not seem to have been widely applied and no guidelines exist on how to implement it. The two specific objectives of this scoping review were: (1) to describe the theoretical context in which PU was established, (2) to describe how researchers apply PU and related methodological issues.

METHODS

We searched for all articles published until 6th of February 2020, mentioning "Proportionate Universalism" or its synonyms "Targeted universalism" OR "Progressive Universalism" as a topic in all Web of Science databases.

RESULTS

This review of 55 articles allowed us a global vision around the question of PU regarding its theoretical foundations and practical implementation. PU principle is rooted in the social theories of universalism and targeting. It proposes to link these two aspects in order to achieve an effective reduction of health inequalities. Regarding practical implementation, PU interventions were rare and led to different interpretations. There are still many methodological and ethical challenges regarding conception and evaluation of PU interventions, including how to apply proportionality, and identification of needs.

CONCLUSION

This review mapped available scientific literature on PU and its related concepts. PU principle originates from social theories. As highlighted by authors who implemented PU interventions, application raises many challenges from design to evaluation. Analysis of PU applications provided in this review answered to some of them but remaining methodological challenges could be addressed in further research.

Differentiated routes to vulnerability: Marital status, children, gender and poverty

This study compares poverty risks between two types of transition involving family status, which the life course perspective considers risky events: divorce and widowhood. The case study is Israeli society, characterized by high fertility rates and a high risk of poverty. The study examines the relationship between marriage dissolution and the risk of poverty, distinguishing between divorce and widowhood, and how they are affected by the intersection of gender and number of children in the household. Based on unique administrative panel data, we studied all women and men in Israel, aged 18-60 in 2003, who married in 2003 and were widowed or divorced by 2015, as well as a random sample of 20 % of all women and men in Israel who married in 2003 and remained married until 2015. Fixed effects models calculated the probability of women and men becoming poor. Results revealed a gendered effect of entering into poverty that largely depends on how the marriage ended and the number of children in the household. Divorce increases poverty risks for women and decreases them for men. However, for both genders, the combination of divorce and more children at home increases poverty. In contrast, widowhood tends to increase poverty for men, but only for women does the poverty risk increase as the number of children rises. Findings are discussed in the context of high fertility rates, Israeli welfare policy and the economic vulnerability associated with parents' childcare responsibilities.

Household Debt, Maternal Well-Being, and Child Adjustment in Germany: Examining the Family Stress Model by Family Structure

The amount of household debt tripled globally over the last decades and a sizable share of individuals and families are overindebted due to mortgages, credit cards, or consumer debt. Yet research on the distribution of debt across families, and potential ripple effects of the psychological burden related to debt on well-being and family relations, remains sparse. Our study aims to fill these gaps by examining the socio-demographic profiles of families that have accumulated household debt and the unique role that the psychological burden related to debt plays on associations between mothers' well-being, parental dynamics, and child adjustment based on the Family Stress Model (FSM). We used representative survey data collected in 2019 from Germany (N = 3271), which is one of the richest economies worldwide, yet about 10% of adults reported to be overindebted. Logistic regression results showed that single mothers were less likely to have debt compared to mothers in two-parent families. However, both single mothers and mothers in stepfamilies with high levels of perceived economic strain were particularly likely to report having debt. Structural equation modeling yielded that the links between the psychological burden of debt, maternal well-being, parental dynamics, and child adjustment were largely in line with the FSM, except for single mothers. We conclude that persisting financial disparities by family structure may be partially fostered by unique characteristics of the German welfare state, such as promoting more a traditional two-parent norm, and discuss our findings in light of practical implications.

Adolescent depression, early psychiatric comorbidities, and adulthood welfare burden: a 25-year longitudinal cohort study

PURPOSE

Depression at all ages is recognized as a global public health concern, but less is known about the welfare burden following early-life depression. This study aimed to (1) estimate the magnitude of associations between depression in adolescence and social transfer payments in adulthood; and (2) address the impact of major comorbid psychopathology on these associations.

METHODS

This is a longitudinal cohort study of 539 participants assessed at age 16-17 using structured diagnostic interviews. An ongoing 25-year follow-up linked the cohort (n = 321 depressed; n = 218 nondepressed) to nationwide population-based registries. Outcomes included consecutive annual data on social transfer payments due to unemployment, work disability, and public assistance, spanning from age 18 to 40. Parameter estimations used the generalized estimating equations approach.

RESULTS

Adolescent depression was associated with all forms of social transfer payments. The estimated overall payment per person and year was 938 USD (95% CI 551-1326) over and above the amount received by nondepressed controls. Persistent depressive disorder was associated with higher recipiency across all outcomes, whereas the pattern of findings was less clear for subthreshold and episodic major depression. Moreover, depressed adolescents presenting with comorbid anxiety and disruptive behavior disorders evidenced particularly high recipiency, exceeding the nondepressed controls with an estimated 1753 USD (95% CI 887-2620).

CONCLUSION

Adolescent depression is associated with considerable public expenditures across early-to-middle adulthood, especially for those exposed to chronic/persistent depression and psychiatric comorbidities. This finding suggests that the clinical heterogeneity of early-life depression needs to be considered from a longer-term societal perspective.

Theoretical and practical challenges of proportionate universalism: a review

OBJECTIVE

In 2010, the principle of proportionate universalism (PU) has been proposed as a solution to reduce health inequalities. It had a great resonance but does not seem to have been widely applied and no guidelines exist on how to implement it.The two specific objectives of this scoping review were: (1) to describe the theoretical context in which PU was established, (2) to describe how researchers apply PU and related methodological issues.

METHODS

We searched for all articles published until 6th of February 2020, mentioning "Proportionate Universalism" or its synonyms "Targeted universalism" OR "Progressive Universalism" as a topic in all Web of Science databases.

RESULTS

This review of 55 articles allowed us a global vision around the question of PU regarding its theoretical foundations and practical implementation. PU principle is rooted in the social theories of universalism and targeting. It proposes to link these two aspects in order to achieve an effective reduction of health inequalities. Regarding practical implementation, PU interventions were rare and led to different interpretations. There are still many methodological and ethical challenges regarding conception and evaluation of PU interventions, including how to apply proportionality, and identification of needs.

CONCLUSION

This review mapped available scientific literature on PU and its related concepts. PU principle originates from social theories. As highlighted by authors who implemented PU interventions, application raises many challenges from design to evaluation. Analysis of PU applications provided in this review answered to some of them but remaining methodological challenges could be addressed in further research.

Understanding lone mothers' high poverty in Germany: Disentangling composition effects and effects of lone motherhood

Lone mothers are among the groups most affected by income poverty in Germany. Previous research shows that both lone mothers' social composition (e.g. employment status, age, number of children) and the institutional context (e.g. family and labour market policies) are crucial for explaining this high vulnerability. Yet we know little about the underlying mechanisms. Hence, this study develops a theoretical framework that disentangles effects of composition (selection into lone motherhood) and lone motherhood per se (shaped by institutional contexts) on lone mothers' poverty. Three major routes to lone motherhood can be identified that differ regarding their timing, selectivity and related risk of poverty: lone motherhood after marriage, after cohabitation, and out-of-relationship child birth. Using data from the German Socio-Economic Panel, this study first analyses the relationship between the three routes and poverty before and during lone motherhood. Second, conditional difference-in-differences models are used to identify the lone motherhood effect on lone mothers' poverty controlling for composition. Results reveal that two years prior to the transition, all, but particularly cohabiting to-be lone mothers, already show notably higher poverty rates than women who do not experience lone motherhood. Moreover, divorced lone mothers face the highest poverty-enhancing effect of lone motherhood on poverty.

Single Mothers’ Perspectives on the Combination of Motherhood and Work

This study aims to define the perspectives taken by single mothers when combining work and motherhood in a stressful work–life constellation. One of the challenges for single mothers after divorce is to find a work–life balance in their single-parent family system. Regarding work-life balance, we take a General Strain Perspective, describing the work-life conflict as a combination of financial strain and role strain. We argue that both strains are the most problematic for single mothers in comparison to their married and/or male counterparts, as both finances and parenthood ideologies are more under pressure. For this reason, we explore how single mothers coped with this strain, answering the question: ‘Which perspectives on the combination motherhood and work do single mothers take in their attempt to balance role strain and financial strain after divorce?’ To answer this research question, we used a qualitative approach, based on 202 in-depth interviews with single mothers in Belgium. These interviews involved two groups: A primary research population of 13 single mothers and an elaborative research population of 189 single mothers. Timelines were used to structure the single mothers’ narratives. The analysis resulted in the contruction of a typology of four different perspectives based on how single mothers dealt with maternal role strain and financial strain: the re-invented motherhood perspective, the work-family symbiosis perspective, the work-centered motherhood perspective and the work-family conflicted perspective. We found that perspective of single mothers in their work-life strain can be described by the flexibility and/or strictness in either their motherhood ideology and/or their work context. These results point at the needs for policymakers, employers, and practitioners to focus on initiatives improving the work–life balance of single mothers by reducing financial and role strains.

Associations of Birth Factors and Socio-Economic Status with Indicators of Early Emotional Development and Mental Health in Childhood: A Population-Based Linkage Study

Using a linked population-based database established on healthcare, socio-economic, and survey datasets in British Columbia, Canada, we examined how biological, socio-demographic, and socio-economic status (SES) factors at birth related to children's emotional development and mental health. One analysis examined teacher-rated anxiety, hyperactivity, and aggression for kindergarten children (M_age = 5.7; n = 134,094). Another analysis examined administrative healthcare records comprising of physician-assigned diagnostic codes for mental health conditions (conduct disorder, attention deficit hyperactivity disorder, anxiety disorder and depression) from ages 5 through 15 (n = 89,404). Various factors at birth, including gestational age, birthweight, and maternal demographics, were related to emotional development and mental health in childhood. Across outcomes, low SES indicated detrimental associations with various aspects of children's emotional development and mental health (e.g., adjusted odds of mental health conditions were 25-39% higher for children of low income families versus others). Findings reinforce evidence that poverty (reduction) is a primary public health issue.

Measuring socioeconomic adversity in early life

AIM

Early life adversity leads to enduring effects on physical and mental health, school performance and other outcomes. We sought to identify potentially modifiable factors associated with socioeconomic adversity in early life.

METHODS

We enrolled 1503 pregnant women aged 16-40 years, without pregnancy complications or pre-existing conditions from Shelby County, Tennessee. Social, familial and economic variables were analysed using principal components (PCs) analyses to generate the Socioeconomic Adversity Index (SAI). This was replicated using the National Survey of Children's Health (NSCH). Health and social outcomes were compared across the quintile groups defined by SAI values at the county, state and national levels.

RESULTS

Significant differences occurred across the SAI Quintile-1 to Quintile-5 groups in marital status, household structure, annual income, education and health insurance. Significantly worse health and social outcomes occurred in the lower versus higher SAI quintiles, including maternal depression, parental incarceration, child's birthweight and potential for child abuse. Maternal age and race also differed significantly across the SAI quintiles.

CONCLUSION

Modifiable factors contributing to socioeconomic adversity in early life included marital status, household structure, annual income, education and health insurance. Those exposed to greater socioeconomic adversity as defined by SAI values had significantly worse maternal and child outcomes.

The probability of poverty for mothers after childbirth and divorce in Europe: The role of social stratification and tax-benefit policies

This paper looks at the effects of tax-benefit systems and social stratification determinants on the probability of poverty among mothers after childbirth and divorce/separation. The analysis was carried out for twelve EU countries, which represent a variety of welfare regimes providing different degrees of defamilialisation. We applied the stress-testing methodology using microsimulation techniques as proposed by Atkinson (2009) and carried out a regression analysis of the simulated results. We show that the degree of income replacement provided by the welfare state is higher for childbirth than for divorce. Countries with low post-childbirth poverty include those with an explicit pro-natalist orientation and socio-democratic regimes. High post-childbirth poverty rates are found in pro-traditional and South European conservative countries, and especially in the liberal regimes. The same is true for the post-divorce poverty rates. Moreover, our findings confirm that the mother's occupational class has a statistically significant effect for predicting poverty in the case of both events, with a stronger social gradient in case of divorce. Cross-country variation in the social gradient for post-childbirth poverty was insignificant. For post-divorce poverty we find weaker social class effects in the highly defamilialised welfare systems (Scandinavian countries and France) and stronger social class effects in the UK and the post-socialist countries.

Redistributional Policy in Rich Countries: Institutions and Impacts in Nonelderly Households

We review research on institutions of redistribution operating in high-income countries. Focusing on the nonelderly, we invoke the concept of the household income package, which includes income from labor, from related households, and from the state. Accordingly, we assess three institutional arenas: predistribution (rules and regulations that govern paid work), private redistribution (interhousehold transfers), and conventional public redistribution (operating via cash transfers and direct taxes). In each arena, we assess underlying policy logics, identify current policy controversies, summarize contemporary cross-national policy variation, and synthesize existing findings on policy effects. Our assessment of redistributional effects focuses on three core socioeconomic outcomes: low pay, child poverty, and income inequality. We close by assessing how the three institutional arenas perform collectively and by calling for further work on how these institutions change over time and how they affect subgroups differentially.

Do Marriage and Cohabitation Provide Benefits to Health in Mid-Life? The Role of Childhood Selection Mechanisms and Partnership Characteristics Across Countries

Extensive research has found that marriage provides health benefits to individuals, particularly in the U.S. The rise of cohabitation, however, raises questions about whether simply being in an intimate co-residential partnership conveys the same health benefits as marriage. Here, we use OLS regression to compare differences between partnered and unpartnered, and cohabiting and married individuals with respect to self-rated health in mid-life, an understudied part of the lifecourse. We pay particular attention to selection mechanisms arising in childhood and characteristics of the partnership. We compare results in five countries with different social, economic, and policy contexts: the U.S. (NLSY), U.K. (UKHLS), Australia (HILDA), Germany (SOEP), and Norway (GGS). Results show that living with a partner is positively associated with self-rated health in mid-life in all countries, but that controlling for children, prior separation, and current socio-economic status eliminates differences in Germany and Norway. Significant differences between cohabitation and marriage are only evident in the U.S. and the U.K., but controlling for childhood background, union duration, and prior union dissolution eliminates partnership differentials. The findings suggest that cohabitation in the U.S. and U.K., both liberal welfare regimes, seems to be very different than in the other countries. The results challenge the assumption that only marriage is beneficial for health.

Childhood Family Structure and Intergenerational Income Mobility in the United States

The declining prevalence of two-parent families helped increase income inequality over recent decades. Does family structure also condition how economic (dis)advantages pass from parents to children? If so, shifts in the organization of family life may contribute to enduring inequality between groups defined by childhood family structure. Using National Longitudinal Survey of Youth data, I combine parametric and nonparametric methods to reveal how family structure moderates intergenerational income mobility in the United States. I find that individuals raised outside stable two-parent homes are much more mobile than individuals from stable two-parent families. Mobility increases with the number of family transitions but does not vary with children's time spent coresiding with both parents or stepparents conditional on a transition. However, this mobility indicates insecurity, not opportunity. Difficulties maintaining middle-class incomes create downward mobility among people raised outside stable two-parent homes. Regardless of parental income, these people are relatively likely to become low-income adults, reflecting a new form of perverse equality. People raised outside stable two-parent families are also less likely to become high-income adults than people from stable two-parent homes. Mobility differences account for about one-quarter of family-structure inequalities in income at the bottom of the income distribution and more than one-third of these inequalities at the top.

Household structure vs. composition: Understanding gendered effects on educational progress in rural South Africa

BACKGROUND

Demographers have long been interested in the relationship between living arrangements and gendered outcomes for children in sub-Saharan Africa. Most extant research conflates household structure with composition and has revealed little about the pathways that link these components to gendered outcomes.

OBJECTIVES

First, we offer a conceptual approach that differentiates structure from composition with a focus on gendered processes that operate in the household; and second, we demonstrate the value of this approach through an analysis of educational progress for boys and girls in rural South Africa.

METHODS

We use data from the 2002 round of the Agincourt Health and Demographic Surveillance System. Our analytical sample includes 22,997 children aged 6-18 who were neither parents themselves nor lived with a partner or partner's family. We employ ordinary least squares regression models to examine the effects of structure and composition on educational progress of girls and boys.

RESULTS

The results suggest that non-nuclear structures are associated with similar negative effects for both boys and girls compared to children growing up in nuclear households. However, the presence of other kin in the absence of one or both parents results in gendered effects favouring boys.

CONCLUSION

The absence of any gendered effects when using a household structure typology suggests that secular changes to attitudes about gender equity trump any specific gendered processes stemming from particular configurations. On the other hand, gendered effects that appear when one or both parents are absent show that traditional gender norms and/or resource constraints continue to favour boys.

CONTRIBUTION

Despite the wealth of literature on household structure and children's educational outcomes in sub-Saharan Africa, the conceptual basis of these effects has not been well articulated. We have shown the value of unpacking household structure to better understand how gender norms and gendered resource allocations impact education.

Trends and correlates of single motherhood in Kenya: Results from the Demographic and Health Survey

Single motherhood exposes women to poorer socioeconomic and health outcomes, which may also negatively impact child outcomes. The Demographic and Health Surveys of 1989, 1993, 1998, 2003, and 2009 were used to investigate trends over time and factors associated with single motherhood in Kenya. Urban residence, older age, and poorer economic status were associated with single motherhood over time. Women with more than one child, and those with children under 15 years living at home were less likely to be single mothers. As women become single mothers at different stages, targeted and supportive strategies are required to mitigate associated risks.

Addressing Child Poverty: How Does the United States Compare With Other Nations?

Poverty during childhood raises a number of policy challenges. The earliest years are critical in terms of future cognitive and emotional development and early health outcomes, and have long-lasting consequences on future health. In this article child poverty in the United States is compared with a set of other developed countries. To the surprise of few, results show that child poverty is high in the United States. But why is poverty so much higher in the United States than in other rich nations? Among child poverty drivers, household composition and parent's labor market participation matter a great deal. But these are not insurmountable problems. Many of these disadvantages can be overcome by appropriate public policies. For example, single mothers have a very high probability of poverty in the United States, but this is not the case in other countries where the provision of work support increases mothers' labor earnings and together with strong public cash support effectively reduces child poverty. In this article we focus on the role and design of public expenditure to understand the functioning of the different national systems and highlight ways for improvements to reduce child poverty in the United States. We compare relative child poverty in the United States with poverty in a set of selected countries. The takeaway is that the United States underinvests in its children and their families and in so doing this leads to high child poverty and poor health and educational outcomes. If a nation like the United States wants to decrease poverty and improve health and life chances for poor children, it must support parental employment and incomes, and invest in children's futures as do other similar nations with less child poverty.

From cradle to grave: tracking socioeconomic inequalities in mortality in a cohort of 11 868 men and women born in Uppsala, Sweden, 1915-1929

BACKGROUND

Ample evidence has shown that early-life social conditions are associated with mortality later in life. However, little attention has been given to the strength of these effects across specific age intervals from birth to old age. In this paper, we study the effect of the family's socioeconomic position and mother's marital status at birth on all-cause mortality at different age intervals in a Swedish cohort of 11 868 individuals followed across their lifespan.

METHODS

Using the Uppsala Birth Cohort Multigenerational Study, we fitted Cox regression models to estimate age-varying HRs of all-cause mortality according to mother's marital status and family's socioeconomic position.

RESULTS

Mother's marital status and family's socioeconomic position at birth were associated with higher mortality rates throughout life (HR 1.18 (95% CI 1.12 to 1.26) for unmarried mothers; 1.19 (95% CI 1.12 to 1.25) for low socioeconomic position). While the effect of family's socioeconomic position showed little variation across different age groups, the effect of marital status was stronger for infant mortality (HR 1.47 (95% CI 1.23 to 1.76); p=0.04 for heterogeneity). The results remained robust when early life and adult mediator variables were included.

CONCLUSIONS

Family's socioeconomic position and mother's marital status involve different dimensions of social stratification with independent effects on mortality throughout life. Our findings support the importance of improving early-life conditions in order to enhance healthy ageing.

Parenting stress and parent support among mothers with high and low education

Current theorizing and evidence suggest that parenting stress might be greater among parents from both low and high socioeconomic positions (SEP) compared with those from intermediate levels because of material hardship among parents of low SEP and employment demands among parents of high SEP. However, little is known about how this socioeconomic variation in stress relates to the support that parents receive. This study explored whether variation in maternal parenting stress in a population sample was associated with support deficits. To obtain a clearer understanding of support deficits among mothers of high and low education, we distinguished subgroups according to mothers' migrant and single-parent status. Participants were 5,865 mothers from the Growing Up in Scotland Study, who were interviewed when their children were 10 months old. Parenting stress was greater among mothers with either high or low education than among mothers with intermediate education, although it was highest for those with low education. Support deficits accounted for around 50% of higher stress among high- and low-educated groups. Less frequent grandparent contact mediated parenting stress among both high- and low-educated mothers, particularly migrants. Aside from this common feature, different aspects of support were relevant for high- compared with low-educated mothers. For high-educated mothers, reliance on formal childcare and less frequent support from friends mediated higher stress. Among low-educated mothers, smaller grandparent and friend networks and barriers to professional parent support mediated higher stress. Implications of differing support deficits are discussed.

Universalism under siege? Exploring the association between targeting, child benefits and child poverty across 26 countries

The long-standing wisdom that universally designed benefits outperform targeted benefits in terms of poverty reduction has come under siege. Recent empirical studies tend to find that targeting is not necessarily associated anymore with lower levels of poverty reduction. In this study, we investigate for a broad set of European countries (1) the relationship between child benefits and child poverty reduction; (2) whether a universal or targeted approach is more effective in reducing child poverty; and (3) the causal mechanisms explaining the link between (1) and (2). In doing so, we take into account the general characteristics of the child benefit system, the size of the redistributive budget and the generosity of benefit levels. In contrast to previous studies, we construct an indicator of targeting that captures the design instead of the outcomes of child benefit systems. We find that targeting towards lower incomes is associated with higher levels of child poverty reduction, conditional on the direction of targeting and the characteristics of the benefit system.

Keeping it in the family: the self-rated health of lone mothers in different European welfare regimes

This study examines whether health inequalities exist between lone and cohabiting mothers across Europe, and how these may differ by welfare regime. Data from the European Social Survey were used to compare self-rated general health, limiting long-standing illness and depressive feelings by means of a multi-level logistic regression. The 27 countries included in the analyses are classified into six welfare regimes (Anglo-Saxon, Bismarckian, Southern, Nordic, Central East Europe (CEE) (new EU) and CEE (non-EU). Lone motherhood is defined as mothers not cohabiting with a partner, regardless of their legal marital status. The results indicate that lone mothers are more at risk of poor health than cohabiting mothers. This is most pronounced in the Anglo-Saxon regime for self-rated general health and limiting long-standing illness, while for depressive feelings it is most pronounced in the Bismarckian welfare regime. While the risk difference is smallest in the CEE regimes, both lone and cohabiting mothers also reported the highest levels of poor health compared with the other regimes. The results also show that a vulnerable socioeconomic position is associated with ill-health in lone mothers and that welfare regimes differ in the degree to which they moderate this association.

Experimentation and use of cigarette and other tobacco products among adolescents in the Brazilian state capitals (PeNSE 2012)

INTRODUCTION: Nicotine dependence establishes itself more rapidly among adolescents than among adults. Tobacco occupies the fourth place in the rank of main risk factors for non-communicable diseases in the continent. Studies reveal that other forms of tobacco use have increased among adolescents. METHODS: Were included the 9th grade students from the 26 State Capitals and the Federal District. who were participants of the National Adolescent School-based Health Survey (PeNSE), in 2012. Factors independently associated with experimentation and regular use of cigarettes were investigated by means of multinomial logistic regression, using as reference "never tried a cigarette". The use of other tobacco products included cigar, pipe, narghile and others. RESULTS: Of the in the 61,037 participants in the 26 Brazilian capitals and the Federal District, 22.7% (95%CI 21.7 - 23.5) had experimented cigarettes, 6.1% (95%CI 5.6 - 6.6) are regular smokers and 7.1% (95%CI 6.5 - 7.7) had used other tobacco products, with half of them also being regular smokers. The chances of experimenting and being a regular smoker increased with age and according to the frequency of weekly exposure to other smokers. These chances were also higher among students who worked, who lived in monoparental families or without their parents, and those who felt that their parents would not mind if they smoked. CONCLUSION: Results reinforce the association between social disadvantages and experimenting and regular smoking. In addition, the use of other tobacco products is worthy of attention and may lead to regular smoking.

A multilevel approach for assessing the variability of hepatitis C prevalence in injection drug users by their gathering places

OBJECTIVES

The aim of this study was to investigate the variation in hepatitis C virus (HCV) prevalence in injection drug users (IDUs) by their gathering places, using a multilevel approach.

METHODS

IDUs recruited from their gathering places were invited to respond to a questionnaire on demographics, drug use history, injection behaviors, and methadone treatment. Dried blood spots were collected for HCV antibody testing by ELISA. Factors associated with the anti-HCV test result were explored by linear logistic regression, followed by the evaluation of heterogeneity between gathering places by multilevel analysis.

RESULTS

A total of 622 respondents from 19 gathering places in Hong Kong, recruited between August and September 2011, were evaluated. Anti-HCV seroprevalence was 81.7% (95% confidence interval 78.6-84.7%), ranging from 67% to 100% by gathering place. HCV infection was associated with current practice of injection, needle-sharing, and midazolam injection. On multilevel analysis, there was a modest but significant variation in HCV antibody prevalence by gathering place, adjusted by midazolam injection (adjusted odds ratio (AOR) 3.91) and current injection (AOR 2.88) or injection over a long duration (AOR 3.17).

CONCLUSIONS

There was heterogeneity in HCV antibody prevalence in IDUs by gathering place, while the influence of injection behaviors varied, suggesting interactivity between factors at the individual and group levels.