We are far from a complete understanding of the causal determinants of health and mortality in the United States. Explosion of new administrative data has opened up new opportunities to study mortality and health disparities. What is the association between homeownership and longevity? How does it vary by race? What is the causal impact of homeownership on longevity?

Objectives To consider trends and disparities in end-of-life health in the US. Methods I use data from the National Health Interview Survey, linked to death records through 2015, for respondents who died at ages 65+ to compare the prevalence of three health outcomes in the last six years of life across time, sex, age, race, and educational attainment. Self-rated health (SRH) is available for respondents interviewed in years 1987–2014, while information on activities of daily living (ADL) and instrumental activities of daily living (IADL) is available for the period 1997–2014. Results By the end of the study period, individuals reported two fewer months of fair/poor health at the end of life than those dying in earlier years. In contrast, time lived with at least one activity limitation at the end of life generally remained comparable. Compared to men, women on average reported an additional year of living with an IADL limitation before death, and an additional eight months with an ADL limitation. Despite sex differences in disability, both sexes reported similar periods of fair/poor SRH before death. Similarly, while individuals who lived to older ages experienced a longer disabled period before death than individuals who died at younger ages, all age groups were equally likely to report fair/poor SRH. Black adults and adults with less formal schooling also spent more time with an end-of-life disability. For men, these racial and socioeconomic disparities lessened as death approached. For women, inequalities persisted until death. Discussion These findings suggest that despite increasing life expectancy, the period of poor health and disability prior to death has not recently been extended. Black women and women with less than a high school degree, require extended support at the end of life.

Oral rotavirus vaccine efficacy is lower in low- and middle-income countries (LMICs) than in high-income countries. The degree to which antibiotic use impacts rotavirus vaccine immunogenicity in LMICs is unknown. Also, few studies have assessed whether efficacy estimates from rotavirus vaccine randomized controlled trials (RCTs) are applicable in realworld settings. To address these gaps, we examined the association between early life antibiotic use on immune response to oral rotavirus vaccines and generalized results from a monovalent rotavirus vaccine trial in Malawi to all trial-eligible children in Malawi. First, we estimated adjusted effect estimates for the association between early life antibiotic use and rotavirus vaccine immunogenicity in the MAL-ED birth cohort study using a modified Poisson regression. Using the parametric g-formula, we then estimated the impact of hypothetical interventions that treated all children and alternatively prevented inappropriate antibiotic treatments on vaccine seropositivity. Finally, we used a weight-based method to generalize results from a monovalent rotavirus vaccine trial in Malawi to a target population of trial-eligible children in the 2015-2016 Malawi Demographic and Health Survey. We found that the prevalence of seropositivity was higher among children who received at least one course of antibiotics than those with no antibiotic exposure. There was no significant difference by the number of antibiotic courses received or total duration of antibiotics. We also iv found that vaccine efficacy against severe and any-severity rotavirus gastroenteritis was higher after weighting to the target population, in part due to differences in nutritional status. These findings illustrate that further investigation into the underlying mechanisms of antibiotic use on the infant gut microbiome and immune response to rotavirus vaccines is needed to identify potential points of intervention. They also demonstrate that rotavirus vaccine efficacy may differ between RCT samples and target populations when these populations differ and there is treatment effect heterogeneity across population subgroups. Overall, findings from this dissertation can help public health officials in LMICs to plan more effective vaccine implementation programs and ensure that vaccines for rotavirus and other disease indications are maximally effective.

Local economic conditions have been found to be highly influential in shaping patterns of gender inequality across the United States. Less attention, however, has been directed toward exploring the role of cultural characteristics, such as gender norms toward women’s leadership and family divisions of labor. Using data from the American Community Survey and the General Social Survey, we examine the relationship between local gender norms and levels of the gender wage gap across US commuting zones. Results indicate that gender egalitarian family norms predict lower gender wage gaps, while norms toward women’s suitability for leadership are unrelated to wage inequality between women and men. Investigating the mechanisms by which local norms relate to gender wage gaps, we find that family gender norms are unrelated to occupational gender segregation. Instead, egalitarian gender norms toward the family division of labor are associated with greater within-occupation wage equality, indicating that women and men in the same occupations have more equitable opportunities and compensation in contexts where family expectations are shared equally.

High-stakes, standardized testing has historically impeded education/career attainment for members of underrepresented minority groups and people needing testing accommodations. This study was to understand how high-stakes, standardized testing, particularly the NCLEX-RN, impacts diversity, equity, and inclusion (DEI) in nursing. This study explored the history, context, perspectives surrounding standardized testing, with a focus on the NCLEX-RN. The authors consider content, form, and delivery of testing, including accommodations. They identify available data and data collection gaps relevant to DEI and the NCLEX-RN. No nursing organization published the national data necessary to evaluate/refine the NCLEX-RN from a DEI perspective. Preliminary nursing studies and data from other professions indicated disparities in testing outcomes. Nursing must determine if prospective nurses are experiencing disparities in testing outcomes. The authors highlight opportunities to advance DEI through improved data collection, reformed licensure processes, and the reframing of standardized testing as one of many tools to determine competency.

The US government continues to ensure education access for all students. Like its predecessor, NCLB, ESSA takes an interest in the success of immigrant students. Under ESSA, federal funds from Title I support low-income children and Title III for English learners and immigrant students. But there is a unique group of immigrant students, the immigrant multilingual deaf learner (IMDL). Despite the provision of law, the intersections of disabilities, being deaf, immigrant, and multilingualism pose more unique challenges that continue to create a dilemma for both classroom teachers, teacher educators, and administrators. This chapter focuses on multilingualism, multilingual education, and the IMDL.

The purpose of this thesis was to study spatial relationships among climate change vulnerabilities in Ethiopia to inform policy and planning and to offer a methodology for studying climate change impacts in areas of the world with limited data. Point data with environmental and social vulnerability variables was used for spatial analyses to determine regions of high vulnerability and their intersections. A case study was included for the capital city, Addis Ababa, to highlight the differences in climate change vulnerability in the urban environment. The findings of this thesis indicate that high social and high environmental vulnerability are most linked in the north central region of the country, and that flood-risk is a driver of environmental vulnerability in Addis, while drought is a driver of environmental vulnerability in agrarian and rural areas. Policy should be tailored on the sub-national level to address these divergent threats and may include strategies like water infrastructure improvements and food assistance.

This study examined whether the addition of household resources via the receipt of the U.S. Earned Income Tax Credit (EITC) affects short-term patterns of parents’ time investments in children, including time spent engaged with children and in activities related to their education. Using difference-in-differences analyses that exploit seasonal variation in federal EITC outlays with nationally representative time-diary data from the 2003 to 2017 American Time Use Survey-Current Population Survey (ATUS-CPS; N = 61,355) merged with state-level data from the University of Kentucky Center for Poverty Research (UKCPR) National Welfare Database, I estimate the plausibly causal effects of predicted EITC receipt on various measures of parents’ time investments in their children. I examine parents’ time spent directly engaged with children in enriching activities like play and reading and in activities related to children’s education among a low-socioeconomic sample (parents with less than a college degree). I find few associations between monthly federal EITC outlays and immediate changes in parents’ time investments, although there was evidence that greater EITC outlays predicted small increases in mothers’ time spent reading with or to children, particularly among mothers with young children, but also small decreases in fathers’ time spent in activities with children, particularly school-age children. Findings suggest that increases in household resources, even relatively small and annual increases, may have short-term effects on parent–child interactions and time use.

Research in environmental sciences has demonstrated that land in close proximity to brownfields and heavily trafficked highways is contaminated with toxic metals. Despite this, little is known about the influence of brownfields and highways on metal levels in residents living nearby. We used data from 774 participants in the Detroit Neighborhood Health Study to estimate the effect of residential proximity to brownfields, highways, and present-day traffic on serum levels of lead, mercury, manganese, and copper using generalized estimating equations. We found that a 1 standard deviation increase in residential brownfield density within 200m was associated with increased serum lead levels (β: 0.04, 95% CI: −0.01, 0.09). The same modeled increase in a subset of historic industrial-use brownfields was associated with elevated serum mercury (β: 0.06, 95% CI: 0.03, 0.09). Increased highway and traffic density was positively associated with serum manganese (β: 0.02, 95% CI: 0.01, 0.04). Highway and traffic density was also positively associated with serum lead (β: 0.02, 95% CI: 0.01, 0.03) after restricting the analysis to participants who did not move during the study follow-up period. These findings draw attention to the importance of remediating polluted post-industrial sites in heavily populated areas, particularly as residents continue to move into densely populated cities around the globe.

Work activation in the US welfare program called Temporary Assistance for Needy Families remains a political football over which both US political parties continue to argue.

Objectives: Retrospective measures of childhood socioeconomic status (SES) in cohort studies of aging that first observe people late in life-such as the Health and Retirement Study (HRS)-are widely used. However, their measurement validity and reliability are unknown. We assess the reliability and validity of the HRS's retrospective measures of parental education and childhood family finances. Methods: We use records for 6,343 HRS sample members who were children in 1940 that have been linked to records from the complete-count 1940 U.S. Census. We assess interrater reliability by comparing (a) retrospective reports of childhood SES collected from sample members in the 1992-2018 HRS to (b) prospective measures of parallel concepts collected from HRS sample members' parents in the 1940 Census. We assess predictive validity by comparing the results of analyses that model later-life outcomes as a function of childhood SES as measured both prospectively and retrospectively. Results: Interrater reliabilities of retrospective measures of parental education are high; however, the same is not true of the retrospective measure of childhood family finances. Both retrospective and prospective measures of childhood SES are predictive of later-life outcomes, and with similar strengths and directions of associations for most outcomes. Discussion: Researchers who rely on retrospective indicators of childhood SES from the HRS should be aware of their measurement properties. They are measured with error, and that error modestly attenuates estimates of their associations with later-life outcomes. However, prospective and retrospective measures of childhood SES have similar predictive validity. These findings should reassure researchers who rely on retrospective measures of childhood SES in the HRS and similarly designed surveys.

The authors investigate coronavirus disease 2019 (COVID-19) risk factors, suitability of online instruction, politics, and institutions’ finances as rationales guiding instructional delivery decisions for fall 2020, after COVID-19’s emergence. Contributions include estimating multinomial logit regressions with mode of delivery as a categorical variable, integrating resource dependence and crisis response as theoretical frames, and introducing new predictor variables, including a measure of local residential access to broadband Internet. Findings suggest that county populations, local political preferences, and the percentage of revenue derived from auxiliary enterprises were consistent predictors of delivery mode. Political parties of an institution’s governor and congressional representative were predictive of delivery mode for institutions in the lowest tercile of endowment per student but not for institutions in the highest tercile. Bottom-tercile institutions substituted from online to in-person reopening as reliance on revenue from auxiliary enterprises increased, but top-tercile institutions appeared only to substitute from hybrid to in-person or from online to hybrid delivery as revenue from auxiliary enterprises or tuition and fees increased

National Health Interview Survey Data from Integrated Public Use Microdata Set (2010-2017) were used to examine associations between health insurance coverage gaps and poverty, non-white race, and unmarried status before and after the implementation of the Affordable Care Act (ACA) in 2014. The 140,341 survey respondents represented 138 million adults over eight years annually, with 15.7% reporting inconsistent health coverage from 2010-2013 and 9.9% from 2014-2017. Survey design adjusted multivariable logistic regression indicated modest changes post ACA. There were limited changes for people of color experiencing insurance gaps after 2014, although American Indians/Alaskan Natives were more likely to experience gaps post ACA. Pre and post ACA divorced adults were more likely to have insurance gaps, while adults below 200% FPL and those in the West/Northeast improved compared to the South. Generally, odds of experiencing coverage gaps were higher for marginalized populations and slightly declined after 2014, suggesting the need to prioritize expanded eligibility.

This paper estimates the effects on local labor market outcomes (employment rates, real wages, real earnings) of local labor demand shocks to different types of occupations. Occupations are divided into three groups, "high, middle, and low," with occupations differing in wages paid and education credentials required. Effects are considered on both workers with less than a four-year college degree and workers with a bachelor's degree or higher. The strongest benefits for labor market outcomes come from demand shocks to "mid jobs." Mid-job demand shocks particularly benefit less-educated workers. High-job demand shocks often hurt labor market outcomes for less-educated workers, in part because such shocks push up local prices. Low-job demand shocks sometimes improve labor market outcomes for less-educated workers, and sometimes damage labor market outcomes for more-educated workers. Estimated labor demand effects also vary in different types of local labor markets. For example, when baseline local labor market conditions are tight (high baseline employment rate), less-educated workers gain more in real earnings from low-demand shocks, and lose more in real earnings from high-demand shocks.

Carl Samson October 13, 2022·2 min read Over 13.3 million Asian Americans will be eligible to vote in November’s midterm elections, making up 5.5% of all eligible voters, according to new projections by the Pew Research Center. The estimate comes as Asian Americans continue to be the fastest-growing group of eligible voters in the past two decades, consistent with overall population trends. However, the group’s voter growth has been relatively steady since 2018, with only about a million voters added. Additionally, not all who are eligible to vote are registered to vote. The nonpartisan fact tank’s latest analysis examined the demographics and geographic distribution of Asian Americans who were eligible to vote in 2020. Population projections for the midterms extrapolated 2020 data from the American Community Survey (IPUMS) with the U.S. Census Bureau’s Vintage 2021 estimates for July 2020 and November 2022.

Jones and Marinescu (2022) study the employment effects of a universal cash transfer in Alaska. Using a synthetic control method, they find that the transfer had no negative effects on employment. We reproduce the results using their replication package and investigate if the results hold when using a different software to run the analysis. We also use different estimation techniques and perform sensitivity checks to assess robustness of the results. We find some differences in the size and significance of the average treatment effects on labor force participation and hours worked when we use a different software (R) and various extensions of the synthetic control method. We also find smaller coefficients on part-time employment when including more covariates. However, these differences do not contradict the main conclusion of the paper.

Despite extensive theory and research on the geography of crime, few studies have examined the geography of commercial sex and sex trafficking through a criminological lens. As such, this study explores how social disorganization and routine activities help explain the geography of commercial sex venues, specifically illicit massage businesses (IMBs) that host commercial sex. Because IMBs have also been linked to sex trafficking, understanding which environmental contexts are conducive to their presence may also help identify sex trafficking premises. Findings from hierarchical logistic regression models indicate that both theories point to significant correlates of IMB placement in census tracts and cities, yet neither theory provides a sufficient explanation alone. Implications for future research and policy will be discussed.

Objective: This study examines how occupational resources and demands are associated with parents' childcare time. Background: Scholars recognize parental employment as important for understanding parental time use. Yet, given data limitations, we know relatively little about how strain-based demands (demands that can produce negative psychological states) are associated with parent's time with children. Method: Occupational-level data in the O*NET Database are linked to the American Time Use Survey (ATUS) 2011–2019 (n = 10,274 workday diaries from employed parents in 427 occupations). Ordinary Least Squares regression (OLS) is used to examine how occupational resources and demands are associated with parents' time with children and in childcare on workdays. Results: Mothers in occupations with greater strain-based demands—competitive pressure, aggression-conflict, monotony, and physicality-hazards—spend less time with their children and less time on physical childcare activities. For fathers, associations are weaker with monotonous jobs also associated with less time with children. Workplace conditions, however, are weakly or even positively associated with parents' time on nonworkdays, suggesting that the daily experience of work affects parents' time use at home. Autonomy, an occupational resource, is positively associated with fathers' time with children and with mothers' time in interactive care. Conclusion: Resources and strain-based demands—measured at the occupational-level—are associated with parents' time use. The O*NET Database can be linked to the ATUS to better understand families' time use.

Extensive progress has been made in the fight against child poverty over the past several decades. 1 However, there has been little headway made in narrowing the Black-White child poverty gap (i.e., the disparity in poverty rates between Black children and White children). 2 In 1970, Black children were more than three times as likely to live in poverty than White children, and, as discussed in this brief, the gap is nearly as large today. 3 The Black-White child poverty gap is often used as a tool to understand racial inequality in the United States, 4 and the size and persistence of the Black-White child poverty gap speaks to how deeply embedded racism is in our socioeconomic system. It also calls us to evaluate the role that social policy plays in closing it. While there is ample research examining the effects of social policies and government transfers on raising incomes of children in poverty and reducing child poverty overall, 5 we focus on how effective these policies are at narrowing the Black-White child poverty gap. Future research is needed to examine the question in the context of the changing policy landscape as the pandemic and recent racial justice protests have brought greater focus on social policies and their impact on racial inequality.

In this brief: This brief includes selected findings from a MY-CIL survey that collected information on CIL services for out-of-school youth (OSY) with disabilities from minority backgrounds. The survey was completed by 218 federally funded CILs in 2020 and provided information on the characteristics of OSY that they served, the breadth of services they provided, services they deemed most effective, and challenges CILs faced in increasing and improving services for this population. In this brief, we share findings on the prevalence of OSY among CIL consumers, and the racial, ethnic, and gender composition of their OSY consumers. Overall, we found that all CILs are serving OSY, though to varying degrees. CILs reported that minority youth comprised a large share of OSY consumers for some CILs and much smaller for others. In subsequent briefs, we will share findings from the survey on specific services that CILs reported providing to OSY and on the services CILs deemed most effective. The next briefs will also highlight challenges CILs face in increasing and improving services for this population.