As a doctor, I know first hand the value of healthcare coverage. We can’t predict when we will get sick or when an accident might happen. Even the best diet and exercise plans can’t completely eliminate the threat of cancer, diabetes, or depression. That’s why we must ensure that every Michigander is able to see a doctor when they need one and access high-quality care that they can afford. There are so many things we can’t control when it comes to our health. Access to healthcare should not be one of them. Michiganders today are trapped in a broken health insurance system that leaves too many families suffering from high costs and lack of affordable coverage. Nearly 600,000 Michiganders still lack health insurance coverage, even after the expansion of Medicaid thanks to the Affordable Care Act (Obamacare).1 Many more have subpar insurance that doesn’t adequately pay for care for themselves and their families, and rising healthcare costs are preventing Michiganders from enjoying the freedom that comes with financial and physical well-being. Health insurance premiums in the individual market rose by almost 30 percent in the last year alone. One in five Michiganders aged 25 to 44 reported that they couldn’t access care in the last year because of cost,2 and nearly one in four Michigan households had out-of-pocket health expenses over 10 percent of their total income, which the World Health Organization defines as “catastrophic health expenditure”.3...

Several recent studies have documented an alarming upward trend in disability and functional limitations among US adults. In this study, we draw on the sociomedical Disablement Process framework to produce up-to-date estimates of the trends and identify key social and medical precursors of the trends. Using data on US adults aged 45–64 in the 2002–2016 National Health Interview Surveys, we estimate parametric and semiparametric models of disability and functional limitations as a function of interview time. We also determine the impact of socioeconomic resources, health behaviors, and health conditions on the trends. Our results show increasing prevalence of disability and functional limitations. These trends reflect the net result of complex countervailing forces, some associated with increases in functioning problems (unfavorable trends in economic well-being, especially income, and psychological distress) while other factors have suppressed the growth of functioning problems (favorable trends in educational attainment and some health behaviors, such as smoking and alcohol use). The results underscore that disability prevention must expand beyond medical interventions to include fundamental social factors and be focused on preventing or delaying the onset of chronic health problems and functional limitations.

Is the national rate of teacher attrition in the U.S. higher than expected? In this paper I extend prior research on teacher attrition by conducting a repeated cross-sectional analysis of teacher attrition in relation to arguably similar vocational professions, including nursing, social work, and accounting. I find that the national rate of teacher attrition has remained strikingly stable over time at around 8 percent and exhibits less variation than comparable professions. Teachers and nurses share similar rates of attrition. A decline in the labor force leaver rate among older teachers approaching retirement explains a small decrease in the overall attrition rate between 2001 and 2018.

Although the measurement of intergenerational income mobility has seen a rapid increase in attention and policy discussions, similar examinations of educational mobility in the U.S. are lacking. This paper begins to fill this gap by documenting differences in educational mobility across time (1982-2004) and geography (U.S. states). The study complements recent estimates of intergenerational income mobility because educational mobility both contributes to income mobility and is a target for education policies. We both develop a method to compute intergenerational correlation coefficients which respects the unique properties of education attainment, as well as utilize standard measures in the literature. While naive intergenerational regressions of years attained suggest a slight increase in mobility over the sample period, we find that mobility fluctuated: decreasing over roughly the first decade and increasing in the second. In addition, there is also substantial geographic variation in education mobility. We identify local community and policy factors, such as the existence of high school exit exams, that are correlated with educational mobility as well as a lack of increase in mobility in the South.

We used to marry people to whom we were somehow connected. Since we were more connected to people similar to us, we were also likely to marry someone from our own race. However, online dating has changed this pattern; people who meet online tend to be complete strangers. We investigate the effects of those previously absent ties on the diversity of modern societies. We find that social integration occurs rapidly when a society benefits from new connections. Our analysis of state-level data on interracial marriage and broadband adoption (proxy for online dating) suggests that this integration process is significant and ongoing.

The JPMorgan Chase Institute set out to understand families' out-of-pocket healthcare expenditures and the financial burden they imposed on families over time. Building off a de-identified sample of 4.7 million families with Chase checking accounts, we extended the JPMorgan Chase Institute Healthcare Out-of-pocket Spending Panel (JPMCI HOSP) data asset to include 2017 data, allowing us to explore healthcare out-of-pocket spending trends, as well as a first-ever look at year-over-year trends at the state and country level for different demographic groups. We found that year-over-year growth in out-of-pocket healthcare spending levels accelerated since 2014 to 8.5 percent in 2017. The burden of healthcare spending as a percent of take-home income ticked up slightly. Additionally, in 2017 high-income families experienced the fastest growth in healthcare spending, while low-income families experienced the highest growth in healthcare spending burden. Moreover, families in Utah spent the most on and were the most burdened by out-of-pocket healthcare spending, while families in California experienced the highest growth in spending levels. Finally, out-of-pocket healthcare spending grew the most at hospitals and 'other medical services, equipment, and labs' and decreased at drug stores for the third consecutive year. These findings show that out-of-pocket health care costs are on the rise and consuming a larger share of household budgets. Out-of-pocket healthcare costs affect decisions about whether and when to seek medical care, so it is critical that we . . .

Teaching to Change the World is an up-to-the-moment, engaging, social justice-oriented introduction to education and teaching, and the challenges and opportunities they present. Both foundational and practical, the chapters are organized around conventional topics but in a way that consistently integrates a coherent story that explains why schools are as they are. Taking the position that a hopeful, democratic future depends on ensuring that all students learn, the text pays particular attention to inequalities associated with race, social class, language, gender, and other social categories and explores teachers’ role in addressing them.

It is well known that children from single parent families have poorer outcomes, on average, than children from two-parent families. The family processes that produce divergent outcomes are less well understood. Based on data from the 2011-2015 National Health Interview Survey, I leverage the case of military families with deployment and examine the impacts of family structure and family process on childrens psychological wellbeing and school attendance behavior. Using Cronbach's alpha and linear regressions, this study confirms family structure model, as children from military families with deployment and other single-parent families have lower levels of psychological wellbeing than children from two-parent families. Family processes, defined as parental psychological and physical wellbeing, explain away the impacts of family structure; once added, children from military families show similar results as children from two-parent families. These findings suggest that family process explains more variations in childrens mental and school outcomes than family structure.

Blacks and whites in the United States adopt widely different parental behaviors, but the underlying causes of these differences are not well understood. This paper documents large scale increases in cognitively stimulating parenting among Southern black mothers who came of age in the period immediately following the Civil Rights Movement. The total magnitude of these improvements was approximately .5 standard deviations between the 1957 and 1964 birth cohorts, while no significant trends occurred among blacks outside of the South or among whites from any region.

The Family and Medical Leave Act (FMLA) of 1993 was implemented with the goal of helping employees better balance their work and family responsibilities by allowing them to take unpaid, job-protected leave for specified family and medical reasons, including the birth and care of a newborn child. Prior to 1993, maternity leave legislation in the United States varied from state to state. The implementation of the FMLA thus created a “natural experiment” via which we can study the effect of the law on divorce across states. We postulate that increased maternity leave reduces stress in the household after the birth of a child, leading to greater marital satisfaction and reducing the likelihood of divorce. Using data from the March Current Population Survey (CPS) and difference-in-difference techniques, we examine the effect of the FMLA on divorce rates at the state level. Results indicate that the FMLA had a negative and statistically significant effect on divorce rates in all states for women with a child aged between 5 and 18 years, with the effect being greatest in states mandating short maternity leave pre-FMLA. When sample weights are applied, a negative and statistically significant effect is observed only for those states having no maternity legislation and those states mandating short maternity leave pre-FMLA.

Investigating the “physics” of food crises consists in identifying features which are common to all large-scale food crises. One element which stands out is the fact that during a food crisis there is not only a surge in deaths but also a correlative temporary decline in conceptions and subsequent births. As a matter of fact, birth reduction may even start several months before the death surge and can therefore serve as an early warning signal of an impending crisis. This scenario is studied in three cases of large-scale food crises. Finland (1868), India (1867–1907), China (1960–1961). It turns out that between the regional amplitudes of death spikes and birth troughs there is a power law relationship. This confirms what was already observed for the epidemic of 1918 in the United States (Richmond et al. 2018b). In a second part of the paper we explain how this relationship can be used for the investigation of mass-mortality episodes in cases where direct death data are either uncertain or nonexistent.

The employment rate among non-elderly adults in the US remains low by historical standards and in comparison to other rich countries. This column reviews the evidence on the main causes of the secular decline in employment since the turn of the century. Labour demand factors – notably import competition from China and the rise of industrial robots – emerge as the key drivers. Some labour supply and institutional factors also have contributed to the decline, but to a lesser extent.

More than half of the US rural population lives inside metro or micropolitan areas and even at more disaggregated scales, such as the census tracts, most spatial units mix rural and urban population. At a national scale, only 30% of the country are inhabited by 100% urban or 100% rural population, implying that more than two third of the US territory are somewhere in between both situations. As the rural/urban dichotomy appears today to be blurred by the emergence of new phenomena like rurbanization or exurbanization, our perception of rural America may be somewhat twisted and the reality of rural areas underplayed. This paper focuses on using finer-grade spatial units such as the census blocks and block groups, in order to provide new elements about the extension, localization and characteristics of rural America as well as about its inner dynamics. To that end, we analyze and process geographical and social data at these two levels of information, and use population density as a main factor of analysis. This allows us not only to propose new measurement of the extent of rural space in the USA but also to propose a new vision of its spatial dynamics by studying how several social indicators such as income, median age or sex ratio reveal regional and micro-regional variations and situations in the rural part of the US.

The cohorts of women born at the turn of the 20th century increased markedly their participation in the labor market when older. These are the first cohorts who worked after their childbearing years. In this paper, we document a link between their work behavior and the Great Depression. We show that the 1929 Crash attracted young married women 20 to 34 years old in 1930 (whom we name D-cohort) into the labor market, possibly via an added-worker effect. Using several years of Census micro data, we further document that the same cohort remained or re-entered the labor market in the 1940s and 1950s and that its entire life cycle labor supply is tightly linked to the conditions dating back to the Great Depression. We argue that these facts are consistent with the hypothesis of a labor supply shift for this cohort triggered by the 1929 Crash.

After more than a century of convergence, the economic fortunes of rich and poor regions of the United States have diverged dramatically since 1980. The richest cities now have per capita incomes almost 40% greater than the nation as a whole, while the poorest ones have incomes 25% smaller. In this paper I use counterfactual simulations based on Census microdata to understand the dynamics of regional divergence. I first show that regional divergence has largely resulted from the richest people and places pulling away from the rest of the country. I then estimate the relative contributions to regional divergence of two major socioeconomic trends of the last 40 years: the sorting of people across metro areas by income level and the national rise in income inequality. I show that the national rise in income inequality is sufficient on its own to account for more than half of the observed divergence across regions, while income sorting on its own accounts for less than a quarter. The major driver of regional economic divergence is national-level income dispersion that has exacerbated preexisting spatial inequalities.

Both scholars and the public have been fascinated by the question of whether parenting increases adults’ wellbeing, or reduces it. Yet despite of decades of research on the topic, the answer to it remains unclear. Using a novel, new source of nationally representative data, the Wellbeing Module of the American Time Use Survey (2010, 2012, 2013), this study aims to resolve this debate by investigating whether parenthood may have both positive and negative effects on adults’ wellbeing, whether the parenting wellbeing gap emerges during certain activities (i.e., market work, nonmarket work and leisure), or in the presence or absence of children; and whether it is driven by women more so than men. Our results reveal that a wellbeing gap exists, but in a far more complex way than previous research has suggested. We find that parents experienced more positive affect than adults who were not raising children, but also more negative affect. This pattern, however, only existed during non-market work, and leisure—not during paid labor—and in the presence of children. Contrary to our expectations, these patterns were the same for men and women.

American Children are poorer at birth than at subsequent childhood ages. We investigate what maternal sociodemographic factors are associated with elevated poverty rates around the time of giving birth in the American Community Survey, Panel Study of Income Dynamics, and Survey of Income and Program Participation (SIPP). The increase in odds of poverty from having recently given birth declined between 2005 and 2015. Having recently given birth increased poverty odds between 2 and 5 times more for women who did not graduate from high school compared with college graduates. In the SIPP, we also estimate odds of entering or exiting poverty immediately after a birth. The odds of entering poverty when having a birth were elevated most by being unmarried just before the birth. For Black women, having a birth was associated with both a lower chance of entering poverty and a lower chance of exiting from poverty.

In communities across the country, many employers are having trouble finding enough skilled workers. They may be overlooking an untapped resource. A large share of immigrant workers are in lower-skilled jobs, however, with the right access to education and training they need to advance their careers, many have the potential to meet these labor force needs. Workforce development services could help them develop their skills, earn higher wages to support themselves and their families, and meet employer demand. Immigrants make up one out of six workers in the United States. They are an often overlooked but vital part of local economies and, therefore, should be a part of local workforce development strategies. Middle-skilled jobs are an avenue for many of these workers to get good jobs without needing a fouryear degree. And employers have expressed a need for workers with bilingual and cultural skills to serve an increasingly diverse public. Many cities and organizations are engaged in upskilling their immigrant workforce, though it is challenging to serve this population effectively, and there is not much systematic knowledge about the most effective way to address barriers and design training for this group. In this report, we examine the size and characteristics of the potentially untapped immigrant workforce and the barriers to and opportunities for education, training, and workforce services. We provide national and metropolitan-level statistics to . . .

Much of the world's poor remain invisible and uncounted by their governments. What affects the willingness of governments to register their citizens, and the decision by citizens to be seen? I argue that an exclusionary logic underpins civil registration in much of the developing world due to fiscal and political incentives to prioritise registering the rich over the poor. The rich will only select into registration, however, when the returns to identity formalisation are structured to provide benefits by gatekeeping access to 'regressive' goods and services. This results in striking inequalities in formal identification and de facto access to the state. Drawing on evidence from Tanzania, I leverage a natural experiment arising from district-level reforms to compulsory birth registration. In a difference-indifferences framework I show these reforms led to substantial increases in registration, especially among elites. Then, using these reforms as an instrument for the possession of a birth certificate, I provide causal evidence on the returns to registration. These are substantial but narrowly targeted: registered citizens are more likely to work in the formal economic sector, have bank accounts, and pay taxes.

Demographic and ecological theories yieldmixed evidence as to whether ethnic enclaves are a benefit or a hindrance to the status attainment of residents and entrepreneurs. This article provides one possible theoretical resolution by separating the positive effects that may emanate among co-ethnic neighbors from the negative effects that may resultwith the concentration of racial or ethnic groups. The theory is tested by analyzing occupational wage attainment and entrepreneurship among African-Americans between 1880 and 1940, a historical context in which Jim Crow laws imposed segregation exogenously. Drawing on crosssectional and panel census data for representative samples of blacks in theUnited States, the results suggest consistent upward occupational mobilityamong residents with same-race neighbors, accompanied with downward mobility among residents who are concentrated in larger racialized enclaves. Both patterns are also observed in the distribution of entrepreneurial activity among blacks during the Jim Crow era.