Author Archives: afscme

Polarization, Participation, and Premiums: How Political Behavior Helps Explain Where the ACA Works, and Where It Doesn’t

Source: Samuel Trachtman, Journal of Health Politics, Policy and Law, Volume 44, Issue 6, December 2019
(subscription required)

From the abstract:
Context:
Political partisanship can influence whether individuals enroll in government programs. In particular, Republicans, ceteris paribus, are less likely to enroll in Affordable Care Act (ACA) individual marketplace insurance than Democrats. The logic of adverse selection suggests low uptake among Republicans would generally put upward pressure on marketplace premiums, especially in geographic areas with more Republican partisans.

Methods:
Using data from Healthcare.gov at the rating area level, this article examines the association between Republican vote share and growth in ACA marketplace premiums, being careful to account for potential confounding variables.

Findings:
Insurers have increased marketplace premiums at higher rates in areas with more Republican voters. In the preferred model specification, a 10-percentage-point difference in Republican vote share is associated with a 3.2-percentage-point increase in average premium growth for a standard plan. A variety of robustness and placebo checks suggest the relationship is driven by partisanship.

Conclusions:
Partisan polarization can threaten the successful implementation of policies that rely on high levels of citizen participation.

Work Scheduling for American Mothers, 1990 and 2012

Source: Peter Hepburn, Social Problems, Latest Articles, October 26, 2019
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From the abstract:
American working conditions have deteriorated over the last 40 years. One commonly-noted change is the rise of nonstandard and unstable work schedules. Such schedules, especially when held by mothers, negatively affect family functioning and the well-being and development of children; they have implications for the intergenerational transmission of disadvantage. This article describes and compares the working schedules—in terms of type, duration, and variability—of American mothers in 1990 and 2012 in an attempt to assess whether nonstandard and unstable schedules are growing more common. Analyses demonstrate that evening work has increased in prevalence for single mothers but not for their partnered peers. Mothers in both single-mother and two-partner households experienced considerably greater within-week schedule variability and higher likelihood of weekend work in 2012 than they did in 1990. These changes resulted from widespread shifts in the nature of work, especially affecting less educated mothers.

Localized Strategies for Addressing the Workforce Crisis in Home Care

Source: Allison Cook, PHI, Issue Brief, November 12, 2019

From the summary:
The United States is facing a home care workforce crisis that profoundly impacts older adults, people with disabilities, and family caregivers. While resolving the crisis will require concerted action at the state and national levels, there is also an important role for local governments and stakeholders to play. This issue brief presents a range of localized strategies for strengthening the home care workforce, along with real-world examples.

Key Takeaways:
• This issue brief presents a range of localized strategies for strengthening the home care workforce, along with examples.
• Local stakeholders are well-placed to identify and implement targeted strategies for strengthening the home care workforce.
• The home care workforce crisis reverberates across local regions, states, and the nation, and must be addressed at each of these levels.

Occupational exposure to disinfectants and asthma incidence in U.S. nurses: A prospective cohort study

Source: Orianne Dumas, Krislyn M. Boggs, Catherine Quinot, Raphaëlle Varraso, Jan‐Paul Zock, Paul K. Henneberger, Frank E. Speizer, Nicole Le Moual, Carlos A. Camargo Jr., American Journal of Industrial Medicine, Early View, November 6, 2019
(subscription required)

From the abstract:
Background:
Exposure to disinfectants among healthcare workers has been associated with respiratory health effects, in particular, asthma. However, most studies are cross‐sectional and the role of disinfectant exposures in asthma development requires longitudinal studies. We investigated the association between occupational exposure to disinfectants and incident asthma in a large cohort of U.S. female nurses.

Methods:
The Nurses’ Health Study II is a prospective cohort of 116 429 female nurses enrolled in 1989. Analyses included 61 539 participants who were still in a nursing job and with no history of asthma in 2009 (baseline; mean age: 55 years). During 277 744 person‐years of follow‐up (2009‐2015), 370 nurses reported incident physician‐diagnosed asthma. Occupational exposure was evaluated by questionnaire and a Job‐Task‐Exposure Matrix (JTEM). We examined the association between disinfectant exposure and subsequent asthma development, adjusted for age, race, ethnicity, smoking status, and body mass index.

Results:
Weekly use of disinfectants to clean surfaces only (23% exposed) or to clean medical instruments (19% exposed) was not associated with incident asthma (adjusted hazard ratio [95% confidence interval] for surfaces, 1.12 [0.87‐1.43]; for instruments, 1.13 [0.87‐1.48]). No association was observed between high‐level exposure to specific disinfectants/cleaning products evaluated by the JTEM (formaldehyde, glutaraldehyde, bleach, hydrogen peroxide, alcohol quats, or enzymatic cleaners) and asthma incidence.

Conclusions:
In a population of late career nurses, we observed no significant association between exposure to disinfectants and asthma incidence. A potential role of disinfectant exposures in asthma development warrants further study among healthcare workers at earlier career stage to limit the healthy worker effect.

Race and Networks in the Job Search Process

Source: David S. Pedulla, Devah Pager, American Sociological Review, OnlineFirst, November 7, 2019
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From the abstract:
Racial disparities persist throughout the employment process, with African Americans experiencing significant barriers compared to whites. This article advances the understanding of racial labor market stratification by bringing new theoretical insights and original data to bear on the ways social networks shape racial disparities in employment opportunities. We develop and articulate two pathways through which networks may perpetuate racial inequality in the labor market: network access and network returns. In the first case, African American job seekers may receive fewer job leads through their social networks than white job seekers, limiting their access to employment opportunities. In the second case, black and white job seekers may utilize their social networks at similar rates, but their networks may differ in effectiveness. Our data, with detailed information about both job applications and job offers, provide the unique ability to adjudicate between these processes. We find evidence that black and white job seekers utilize their networks at similar rates, but network-based methods are less likely to lead to job offers for African Americans. We then theoretically develop and empirically test two mechanisms that may explain these differential returns: network placement and network mobilization. We conclude by discussing the implications of these findings for scholarship on racial stratification and social networks in the job search process.

Status Characteristics, Implicit Bias, and the Production of Racial Inequality

Source: David Melamed, Christopher W. Munn, Leanne Barry, Bradley Montgomery, Oneya F. Okuwobi, American Sociological Review, OnlineFirst Published November 7, 2019
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From the abstract:
Racial stratification is well documented in many spheres of social life. Much stratification research assumes that implicit or explicit bias on the part of institutional gatekeepers produces disparate racial outcomes. Research on status-based expectations provides a good starting point for theoretically understanding racial inequalities. In this context it is understood that race results in differential expectations for performance, producing disparate outcomes. But even here, the mechanism (i.e., status-based expectations) is often assumed due to the lack of tools to measure status-based expectations. In this article, we put forth a new way to measure implicit racial status beliefs and theorize how they are related to consensual beliefs about what “most people” think. This enables us to assess the mechanisms in the relationship between race and disparate outcomes. We conducted two studies to assess our arguments. Study 1 demonstrates the measurement properties of the implicit status measure. Study 2 shows how implicit status beliefs and perceptions of what “most people” think combine to shape social influence. We conclude with the implications of this work for social psychological research, and for racial stratification more generally.

The Constant Caregiver: Work–family Spillover among Men and Women in Nursing

Source: Marci D Cottingham, Jamie J Chapman, Rebecca J Erickson, Work, Employment and Society, OnlineFirst Published November 8, 2019
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From the abstract:
Work–family spillover is a central concept in the work and occupations literature, with prior research detailing its negative outcomes and gendered dimensions. With increased demands for careworkers and more men entering occupations such as nursing, we examine experiences and perceptions of spillover using qualitative data from a diverse sample of 48 US nurses. We find similarities across men and women in terms of exhaustion and stress as well as in anticipating spillover in their careers. Yet, we also find some differences, with men (but not women) highlighting the transfer of emotional capital between work and family. We extend work–family research by broadening the concept of spillover to include its anticipation and the transfer of emotional capital – both aspects that have been previously under-examined. These findings have implications for the retention and support of careworkers and refine the concept of spillover in ways that could apply to various employment sectors.

In the Shadow of State Government: Changes in Municipal Spending After Two Recessions

Source: Rebecca Hendrick, Robert P. Degnan, The American Review of Public Administration, OnlineFirst Published November 6, 2019
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From the abstract:
This research estimates a model of own-source revenue diversification and a model of changes in operational spending in municipal governments from 1997 to 2012 to determine how these governments have adapted to the two significant recessions that occurred during this time period. The first model examines factors that affect revenue diversification, focusing on the state–local fiscal context and how the level of urbanization of the area surrounding the municipalities impacts the effect of state–local context and other factors. The second model examines how municipal governments in the United States have adapted their spending to the two severe recessions of the 2000s, focusing on how state context, revenue diversification, and other factors affect changes in operational spending. Finally, this research also looks at the conditional effects of the size of government on the impact of state context, environmental pressures, and revenue structure on changes in operational spending.

Running While Female: Using AI to Track how Twitter Commentary Disadvantages Women in the 2020 U.S. Primaries

Source: Sarah Oates, Olya Gurevich, Christopher Walker, Lucina Di Meco, Philip Merrill College of Journalism – University of Maryland, The Wilson Center, and Marvelous AI, August 28, 2019

From the abstract:
While there is conclusive research that female political candidates are treated unfairly by traditional media outlets, the volume and pace of information flow online make it difficult to track the differentiated treatment for female candidates on social media in real time. This paper leverages human coding and natural language processing to cluster tweets into narratives concerned with policy, ideology, character, identity, and electability, focusing on the Democratic candidates in the 2020 U.S. Presidential primary election. We find that female candidates are frequently marginalized and attacked on character and identity issues that are not raised for their male counterparts, echoing the problems found in the traditional media in the framing of female candidates. Our research found a Catch-22 for female candidates, in that they either failed to garner serious attention at all or, if they became a subject of Twitter commentary, were attacked on issues of character and identity that were not raised for their male counterparts. At the same time, women running for president received significantly more negative tweets from right-leaning and non-credible sources than did male candidates. Following the first Democratic debates, the individual differences between male and female candidates became even more pronounced, although at least one female candidate (Elizabeth Warren) seemed to rise above the character attacks by the end of the first debates. We propose that by using artificial intelligence informed by traditional political communication theory, we can much more readily identify and challenge both sexist comments and coverage at scale. We use the concept of narratives by searching for political communication narratives about female candidates that are visible, enduring, resonant, and relevant to particular campaign messages. A real-time measurement system, developed by MarvelousAI, creates a way to allow candidates to identify and push back against sexist framing on social media and take control of their own narratives much more readily.

Do US TRAP Laws Trap Women Into Bad Jobs?

Source: Kate Bahn, Adriana Kugler, Melissa Holly Mahoney & Annie McGrew, Feminist Economics, August 19, 2019
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From the abstract:
This study explores the impact of women’s access to reproductive healthcare on labor market opportunities in the US. Previous research finds that access to the contraception pill delayed age at first birth and increased access to a university degree, labor force participation, and wages for women. This study examines how access to contraceptives and abortions impacts job mobility. If women cannot control family planning or doing so is heavily dependent on staying in one job, it is more difficult to plan for and take risks in their careers. Using data from the Current Population Survey’s Outgoing Rotation Group, this study finds that Targeted Restrictions on Abortion Providers (TRAP) laws increased “job lock.” Women in states with TRAP laws are less likely to move between occupations and into higher-paying occupations. Moreover, public funding for medically necessary abortions increases full-time occupational mobility, and contraceptive insurance coverage increases transitions into paid employment.