Health Insurance is a Family Matter is the third of a series of six reports on the problems of uninsurance in the United Sates and addresses the impact on the family of not having health insurance. The book demonstrates that having one or more uninsured members in a family can have adverse consequences for everyone in the household and that the financial, physical, and emotional well-being of all members of a family may be adversely affected if any family member lacks coverage. It concludes with the finding that uninsured children have worse access to and use fewer health care services than children with insurance, including important preventive services that can have beneficial long-term effects.
This is an edited volume reviewing the major means-tested social programs in the United States. Each author addresses a major program or area, reviewing each area’s successes and recommending how to address shortcomings through policy change. In general, our means-tested programs do many things well, but some adjustments to each could make the system much more effective. This book provides policymakers with a broad overview of the issues at hand in each program and how to address them.
On weekday afternoons, dismissal bells signal not just the end of the school day but also the beginning of another important activity: the federally funded after-school programs that offer tutoring, homework help, and basic supervision to millions of American children. Nearly one in four low-income families enroll a child in an after-school program. Beyond sharpening students’ math and reading skills, these programs also have a profound impact on parents. In a surprising turn—especially given the long history of social policies that leave recipients feeling policed, distrusted, and alienated—government-funded after-school programs have quietly become powerful forces for political and civic engagement by shifting power away from bureaucrats and putting it back into the hands of parents. In State of Empowerment Carolyn Barnes uses ethnographic accounts of three organizations to reveal how interacting with government-funded after-school programs can enhance the civic and political lives of low-income citizens.
Many Americans seem convinced that government programs designed to help the poor have failed. Social Programs That Work shows that this is not true. Many programs have demonstrably improved the lives of people trapped at the bottom of the social and economic ladder. Social Programs That Work provides an in-depth look at some of the nation's best interventions over the past few decades, and considers their potential for national expansion. Examined here are programs designed to improve children's reading skills, curb juvenile delinquency and substance abuse, and move people off welfare into the workforce. Each contributor discusses the design and implementation of a particular program, and assesses how well particular goals were met. Among the critical issues addressed: Are good results permanent, or do they fade over time? Can they be replicated successfully under varied conditions? Are programs cost effective, and if so are the benefits seen immediately or only over the long term? How can public support be garnered for a large upfront investment whose returns may not be apparent for years? Some programs discussed in this volume were implemented only on a small, experimental scale, prompting discussion of their viability at the national level. An important concern for social policy is whether one-shot programs can lead to permanent results. Early interventions may be extremely effective at reducing future criminal behavior, as shown by the results of the High/Scope Perry preschool program. Evidence from the Life Skills Training Program suggests that a combination of initial intervention and occasional booster sessions can be an inexpensive and successful approach to reducing adolescent substance abuse. Social Programs That Work also acknowledges that simply placing welfare recipients in jobs isn't enough; they will also need long-term support to maintain those jobs. The successes and failures of social policy over the last thirty-five years have given us valuable feedback about the design of successful social policy. Social Programs That Work represents a landmark attempt to use social science criteria to identify and strengthen the programs most likely to make a real difference in addressing the nation's social ills.
For many Americans who live at or below the poverty threshold, access to healthy foods at a reasonable price is a challenge that often places a strain on already limited resources and may compel them to make food choices that are contrary to current nutritional guidance. To help alleviate this problem, the U.S. Department of Agriculture (USDA) administers a number of nutrition assistance programs designed to improve access to healthy foods for low-income individuals and households. The largest of these programs is the Supplemental Nutrition Assistance Program (SNAP), formerly called the Food Stamp Program, which today serves more than 46 million Americans with a program cost in excess of $75 billion annually. The goals of SNAP include raising the level of nutrition among low-income households and maintaining adequate levels of nutrition by increasing the food purchasing power of low-income families. In response to questions about whether there are different ways to define the adequacy of SNAP allotments consistent with the program goals of improving food security and access to a healthy diet, USDA's Food and Nutrition Service (FNS) asked the Institute of Medicine (IOM) to conduct a study to examine the feasibility of defining the adequacy of SNAP allotments, specifically: the feasibility of establishing an objective, evidence-based, science-driven definition of the adequacy of SNAP allotments consistent with the program goals of improving food security and access to a healthy diet, as well as other relevant dimensions of adequacy; and data and analyses needed to support an evidence-based assessment of the adequacy of SNAP allotments. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy reviews the current evidence, including the peer-reviewed published literature and peer-reviewed government reports. Although not given equal weight with peer-reviewed publications, some non-peer-reviewed publications from nongovernmental organizations and stakeholder groups also were considered because they provided additional insight into the behavioral aspects of participation in nutrition assistance programs. In addition to its evidence review, the committee held a data gathering workshop that tapped a range of expertise relevant to its task.
The strengths and abilities children develop from infancy through adolescence are crucial for their physical, emotional, and cognitive growth, which in turn help them to achieve success in school and to become responsible, economically self-sufficient, and healthy adults. Capable, responsible, and healthy adults are clearly the foundation of a well-functioning and prosperous society, yet America's future is not as secure as it could be because millions of American children live in families with incomes below the poverty line. A wealth of evidence suggests that a lack of adequate economic resources for families with children compromises these children's ability to grow and achieve adult success, hurting them and the broader society. A Roadmap to Reducing Child Poverty reviews the research on linkages between child poverty and child well-being, and analyzes the poverty-reducing effects of major assistance programs directed at children and families. This report also provides policy and program recommendations for reducing the number of children living in poverty in the United States by half within 10 years.
Chronic homelessness is a highly complex social problem of national importance. The problem has elicited a variety of societal and public policy responses over the years, concomitant with fluctuations in the economy and changes in the demographics of and attitudes toward poor and disenfranchised citizens. In recent decades, federal agencies, nonprofit organizations, and the philanthropic community have worked hard to develop and implement programs to solve the challenges of homelessness, and progress has been made. However, much more remains to be done. Importantly, the results of various efforts, and especially the efforts to reduce homelessness among veterans in recent years, have shown that the problem of homelessness can be successfully addressed. Although a number of programs have been developed to meet the needs of persons experiencing homelessness, this report focuses on one particular type of intervention: permanent supportive housing (PSH). Permanent Supportive Housing focuses on the impact of PSH on health care outcomes and its cost-effectiveness. The report also addresses policy and program barriers that affect the ability to bring the PSH and other housing models to scale to address housing and health care needs.
Few United States government programs are as controversial as those designed to aid the poor. From tax credits to medical assistance, aid to needy families is surrounded by debate—on what benefits should be offered, what forms they should take, and how they should be administered. The past few decades, in fact, have seen this debate lead to broad transformations of aid programs themselves, with Aid to Families with Dependent Children replaced by Temporary Assistance to Needy Families, the Earned Income Tax Credit growing from a minor program to one of the most important for low-income families, and Medicaid greatly expanding its eligibility. This volume provides a remarkable overview of how such programs actually work, offering an impressive wealth of information on the nation's nine largest "means-tested" programs—that is, those in which some test of income forms the basis for participation. For each program, contributors describe origins and goals, summarize policy histories and current rules, and discuss the recipient's characteristics as well as the different types of benefits they receive. Each chapter then provides an overview of scholarly research on each program, bringing together the results of the field's most rigorous statistical examinations. The result is a fascinating portrayal of the evolution and current state of means-tested programs, one that charts a number of shifts in emphasis—the decline of cash assistance, for instance, and the increasing emphasis on work. This exemplary portrait of the nation's safety net will be an invaluable reference for anyone interested in American social policy.
