Objective To understand geographic variations in clinical retention, a central component of the HIV care continuum and key to improving individual- and population-level HIV outcomes. Design We evaluated retention by US region in a retrospective observational study. Methods Adults receiving care from 2000–2010 in 12 clinical cohorts of the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) contributed data. Individuals were assigned to Centers for Disease Control and Prevention (CDC)-defined regions by residential data (10 cohorts) and clinic location as proxy (2 cohorts). Retention was ≥2 primary HIV outpatient visits within a calendar year, >90 days apart. Trends and regional differences were analyzed using modified Poisson regression with clustering, adjusting for time in care, age, sex, race/ethnicity, and HIV risk, and stratified by baseline CD4+ count. Results Among 78,993 adults with 444,212 person-years of follow-up, median time in care was 7 years (Interquartile Range: 4–9). Retention increased from 2000 to 2010: from 73% (5,000/6,875) to 85% (7,189/8,462) in the Northeast, 75% (1,778/2,356) to 87% (1,630/1,880) in the Midwest, 68% (8,451/12,417) to 80% (9,892/12,304) in the South, and 68% (5,147/7,520) to 72% (6,401/8,895) in the West. In adjusted analyses, retention improved over time in all regions (p<0.01, trend), although the average percent retained lagged in the West and South vs. the Northeast (p<0.01). Conclusions In our population, retention improved, though regional differences persisted even after adjusting for demographic and HIV risk factors. These data demonstrate regional differences in the US which may affect patient care, despite national care recommendations.

Women age 65 and older are much more likely to be poor than their male counterparts—and older, minority, and unmarried women are at greatest risk. The chart below replicates findings in a new report by the National Institute on Retirement Security, but uses an alternative measure of poverty that takes into account out-of-pocket medical expenses and other factors in addition to income. Hispanic senior women have the highest poverty rate of any group—31 percent, compared with 28 percent of Hispanic men over the age of 65. Senior women who never married have a similarly high poverty rate (29 percent); comparatively, senior men who never married have a poverty rate of 21 percent. As women get older, they also become more likely to be in poverty: 17 percent of women between the ages of 70–79 and 22 percent of women 80 and over are in poverty. Meanwhile, men in these age groups have a poverty rate of 11 percent and 17 percent, respectively.

Living arrangements are often influenced by disability status, and co-resident caregivers may facilitate access to health care, especially for community-dwelling older adults with disabilities. Despite this, we know very little about how disability status and household composition work together to affect health services use. Using data from the National Health Interview Survey (20092011; n = 16,720), this study investigates (a) how access to medical care varies by disability status and household composition and (b) whether the relationship between household composition and health care access differs by disability status. We find that the risk of delayed care due to cost or lack of transportation is highest for older adults living alone or with non-spousal others. Older adults living alone without disabilities have lower odds of delayed care due to difficulty making a timely appointment than older adults living with a spouse. Furthermore, we find that older adults living alone with disabilities have elevated odds of delayed care for any reason. These findings can help target interventions to improve health care access through programs such as home- and community-based care and non-emergency medical transportation.

The economic status of women in Georgia is a key factor in the overall health and future of the states economy. Women represent a majority of Georgias adult population and nearly half of the workforce. In more than half of all Georgia households with children, women are primary or co-breadwinners. Despite their importance, women face a host of barriers keeping them and Georgias economy, from reaching their full potential. Women working full-time in Georgia earn, on average, 70 cents for every dollar white men earn. The gender wage gap is even wider once part-time workers are taken into account.

The book examines African American cultural forms through the lens of census history to tell the story of how U.S. officialdom in particular the Census Bureau placed persons of African descent within a shifting taxonomy of racial difference, and how African American writers and intellectuals described a far more complex situation of interracial social contact and intra-racial diversity. What we now call African American identity and the literature that gives it voice emerged out of social, cultural, and intellectual forces that fused in Harlem roughly one century ago.

This chapter is designed to draw the reader into the conceptual origins of the book using firsthand experience. As the son of “white” Cuban exiles, the conventional narrative about Cuban immigration to the USA has often been written in my favor (or from a white, privileged perspective), with romantic, rose-colored glasses void of any critical intra-group race-centered perspectives. Here I invoke a reflexive approach, taking the reader to my short time in Cuba as a visiting Master’s degree student in early 2000 amidst the Elián González international custody debacle, when a revealing bus stop conversation inspired me to explore how racial identities have been constructed in the Miami Cuban ethnic enclave and as to how they are related to disparate economic realities of Cubans based on race. I briefly explain the salience of this book, its overall contribution to the vast immigration literature, and describe the methodology and the organizational path (chapter summaries) for the rest of the book.

This study intended to identify the presence of an emotional shock in women during the utilization of technological artefacts, according to their previous learning experience of abstract cognitive abilities. This study was carried out in a specific context called: Urban Zone, Central Region, which covers the 4 municipalities of Querétaro, Mexico, excluding the rural areas. Taking a representative sample, exclusively for a manufacturing company in the Municipality of Querétaro, 24 women were surveyed and it was verified that there is a relationship between the evaluation of these cognitive abilities and the presence of some type of emotional shock. Some of the supposed causes of the phenomenon to be observed (style of learning and use of technology) were taken as independent variables and the possible effect (emotional shock or presence of anxiety or emotional decomposition) as dependent variable. The results by the measuring instrument showed that 63 percent of the interviewed women have experienced some kind of emotional shock during the use of technological artefacts.

In 2015, America’s Health Rankings ranked Minnesota as the fourth healthiest state in the United States. Carver County, Minnesota has been considered the healthiest county in the entire state from 2013 to the present; this rank is measured by 1) length of life and 2) how healthy people feel during their lifetime (County Health Rankings, 2016). The high health ranking achieved by Carver County over the past three years paints the picture of a healthy population as a whole, but hidden among these statistics may be tremendous disparities. In 2013 the Community Action Partnership conducted a needs assessment for Scott, Carver, and Dakota counties in order to learn the greatest needs of residents in these communities. Then in 2014, Carver County recruited Wilder Research to conduct a needs assessment for the county. Carver County Public Health received a Statewide Health Improvement Plan (SHIP) grant, which requires “high-need and high-risk populations be targeted for services”. Wilder Research’s need assessment aimed to assist Carver County in prioritizing where the grant funded activities should be focused. Carver County Public Health . . .

The number of older Hispanics in the United States is growing rapidly, and many face significant financial challenges because of employment histories marked by low-earning jobs that do not generally offer retirement benefits. Older Hispanics receive much less income, hold much less wealth, and are much more likely to be impoverished than older non-Hispanic whites. Financial outcomes are significantly worse for older foreign-born Hispanics than for those born in the United States. Among working-age adults, US-born Hispanic men are somewhat less likely to participate in the labor force than non-Hispanic white men, while foreign-born Hispanics are more likely to participate. Hispanic women, especially those born outside the United States, are less likely to work. Hispanics employed full-time earn significantly less than their non-Hispanic white counterparts and are less likely to be covered by an employer-sponsored retirement plan.

Access to IRS personal income tax records improves researchers ability to track U.S. income and inequality, especially at the very top of the distribution (Piketty and Saez 2003). However, rather than following standard Haig-Simons income definitions, tax form income measures were designed to implement the Internal Revenue Code. Using IRS tax record data since 1989 statistically matched to Survey of Consumer Finances and Census data for income sources not available in tax data, we explore the robustness of levels and trends in inequality using the top income literatures tax return market income definition (Saez 2016) to more comprehensive income measures. We find that focusing solely on market income misses the important redistributive effects of government taxes and transfers. In addition, we find that the use of taxable realized capital gains changes the level and trend in top incomes relative to an accrued capital gains measure that is more consistent with Haig-Simons income definitions.

Public interest and public policy attention on the importance of cognitive and social development of young children has increased in recent years, at least in part, because scholars and researchers have found that experiences early in life have critical developmental consequences. Although scholars have generated a great deal of data on young children, relatively little is known about spatial variation in the well-being of young children. This study uses 12 indicators of child well-being to construct a comprehensive composite index of child well-being for children age 0 to 5 in each state in the United States. Examination of the 12 indicators of well-being for young children shows a high level of variation across states. The modest positive correlations among the four domains in the index suggest that they are measuring different elements of well-being. The composite index reveals that the well-being of young children follows a familiar spatial pattern, namely the well-being of young children in states located in the Deep South and the Southwest is relatively poor and the well-being of children in New England and the upper Midwest is relatively good. However, there are a several exceptions to this pattern which underscores the importance of examining the wellbeing of young children separately for all children. This study adds to a growing literature that uses an index of well-being to examine different groups of children.

Background Little is known about diabetes status among U.S. blacks by nativity. This study aims to measure differences in diabetes among U.S. blacks by region of birth and examine potential explanations for subgroup differences. Design Data from 47,751 blacks aged 25–74 pooled from the 2000–2013 waves of the National Health Interview Survey were analyzed. Logistic regression models predicted self-reported diabetes. The roles of education, income, body mass index (BMI), smoking, and duration of U.S. residence were explored. Results Compared to the U.S.-born, foreign-born blacks had significantly lower reported diabetes prevalence (8.94% vs. 11.84%) and diabetes odds (OR 0.75; 95% confidence interval (CI): 0.62, 0.89), adjusting for socio-demographic characteristics. Further inclusion of education, income, household size, and smoking did not appreciably change the OR (OR 0.77; 95% CI: 0.61, 0.86). Including an adjustment for BMI entirely eliminated the foreign-born advantage (OR 0.93; 95% CI: 0.78, 1.11). The foreign born from the Caribbean/Americas had similar diabetes odds compared to the African born. Among the foreign born, an increased duration of U.S. residence was associated with a higher diabetes odds, but these associations . . .

We compile large datasets from Norwegian and US historical censuses to study return migration during the Age of Mass Migration (1850-1913). Return migrants were somewhat negatively selected from the migrant pool: Norwegian immigrants who returned to Norway held slightly lower-paid occupations than Norwegian immigrants who stayed in the US, both before and after moving to the US. Upon returning to Norway, return migrants held higher-paid occupations than Norwegians who never moved, despite hailing from poorer backgrounds. They were also more likely to get married after return. These patterns suggest that despite being negatively selected, return migrants were able to accumulate savings and improve their economic circumstances once they returned home.

The majority of Americans live in suburbs and until about a decade or so ago, most suburbs had been assumed to be non-Hispanic White, affluent, and without problems. However, recent data have shown that there are changing trends among U.S. suburbs. This book provides timely analyses of current suburban issues by utilizing recently published data from the 2010 Census and American Community Survey to address key themes including suburban poverty; racial and ethnic change and suburban decline; suburban foreclosures; and suburban policy.

A key question in the design of public assistance to the needy is how allocation of responsibility for funding and decision-making across different levels of government influences the level and type of assistance provided. The New Deal era was a period in which this allocation changed significantly in the United States, as provision of public assistance shifted from local governments to states and the federal government, accompanied by a large increase in government transfer payments. Focusing on assistance to the elderly and using variation in state laws governing the division of funding between local and state governments for the Old Age assistance (OAA) Program, this paper investigates the responsiveness of OAA payments and recipiency to local government funding shares. Payments per elderly resident were significantly lower in states with higher local funding shares, driven largely by reductions in recipiency. The baseline results suggest that had local governments needed to fund half of OAA payments in 1939, on the lower end of local funding shares prior to the New Deal, the share of the elderly receiving OAA would have been 5 percent rather than 22 percent, and perhaps even lower. More speculative results suggest that greater local funding led to lower representation of blacks among OAA recipients relative to their share of the population, particularly in the South.

Emotional/behavioral difficulties (EBDs) are increasingly diagnosed in children, constituting some of the most common chronic childhood conditions. Left untreated, EBDs pose long-term individual and population-level consequences. There is a growing evidence of disparities in EBD prevalence by various demographic characteristics. This article builds on this research by examining disparities in access to medical care for children with EBD. From 2008 to 2011, using data from the US National Health Interview Survey (N = 31,631) on sample children aged 417, we investigate (1) whether having EBD affects access to care (modeled as delayed care due to cost and difficulty making an appointment) and (2) the role demographic characteristics, health insurance coverage, and frequency of service use play in access to care for children with EBD. Results indicate that children with EBD experience issues in accessing care at more than twice the rate of children without EBD, even though they are less likely to be uninsured than their counterparts without EBD. In multivariable models, children with EBD are still more likely to experience delayed care due to cost and difficulty making a timely appointment, even after adjusting for frequency of health service use, insurance coverage, and demographic characteristics.

I use the American Time Use Survey from 2003 to 2012 to analyze, from a gender and marital status perspective, how the time Mexican immigrants devote to market work, household production, personal care, and leisure activities compare to the corresponding time allocations of US natives. Furthermore, I estimate the effect of duration of residence in the US on the immigrants overall patterns of time use. Time diary evidence indicates that, upon arrival to the US, Mexican immigrant men devote more time to market work and commuting than comparable non-Hispanic natives, regardless of their marital status. On the other hand, Mexican immigrant women devote the same amount of time to these activities as the non-Hispanic reference groups, irrespective of the marital status. In addition, the trend data show that immigrant men decrease their paid work with years since migration while immigrant women increase it. Estimates indicate that, for married immigrant men there is a tradeoff between market work and household work, whereas for single immigrant men the tradeoff is between market work and leisure. Finally, Mexican immigrant women relinquish mostly passive leisure and sleep time to meet demands of family and market work.

The goal of this dissertation is to investigate how geographic, socioeconomic, and industrial factors impact and interact with Latino and Latino immigrant business owners in the United States. Further, this dissertation seeks to investigate the impact of Latino business owners on local economic performance. Essay 1 employs decennial Census Bureau data from cities of 10,000 or more to examine the impact of immigrants in American cities on self-employment and median income. The essay examines the relationships using pooled ordinary least squares and generalized method of moments estimators. The results show that self-employment has a statistically significant and positive impact on median income and immigrant population. When controlling for race populations, lagged immigrant population has a negative impact on self- employment, but removing the Hispanic control causes this relationship to become statistically insignificant. In other words, Hispanics, not other ethnicities, drive much of the self- employment in U.S. cities. The implication is that more attention to helping Hispanic business owners succeed and expand their businesses could benefit the general population of a city through median income growth. Essay 2 employs the Michigan Census Research Data Center to merge three limited-access Census Bureau data sets by individual firm and establishment level to investigate the factors associated with the Latino-owned Business (LOB) location and dynamics over time. The three main LOB outcomes under analysis are as follows: (1) the probability of a business being Latino-owned as opposed to a business being Asian-owned, Black-owned, or White-owned; (2) the probability of new business entry and exit; and (3) LOB employment growth. This paper then compares these factors associated with LOB with past findings on businesses that are Asian- owned, Black-owned, and White-owned. Some notable findings include: (1) only Black business owners are less associated with using personal savings as start-up capital than Latinos; (2) the only significant coefficient on start-up capital source is personal savings and it increases the odds of survival of a Latino business by 4%; (3) on average, having Puerto Rican ancestry decreases the odds of business survival; and (4) LOB are relatively likely to start a business with a small amount of capital, which, in turn, limits their future growth. Essay 3 also takes advantage of the Michigan Census Research Data Center to merge limited-access Census Bureau data with county level information to investigate the impact of Latino-owned business (LOB) employment share on local economic performance measures, namely per capita income, employment, poverty, and population growth. Beginning with OLS and then moving to the Spatial Durbin Model, this paper shows the impact of LOB overall employment share is insignificant. When decomposed into various industries, however, LOB employment share does have a significant impact on economic performance measures. Significance varies by industry, but the results support a divide in the impact of LOB employment share in low and high-barrier industries.