In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
Keeping the economy strong will require addressing two distinct but related problems. Steadily rising federal debt makes it harder to grow our economy, boost our living standards, respond to wars or recessions, address social needs, and maintain our role as a global leader. At the same time, we have let critical investments lag and left many people behind even as overall prosperity has grown. In Fiscal Therapy, William Gale, a leading authority on how federal tax and budget policy affects the economy, provides a trenchant discussion of the challenges posed by the imbalances between spending and revenue. America is facing a gradual decline as debt accumulates and delay raises the costs of action. But there is hope: fiscal responsibility aligns with both conservative and liberal goals and citizens of all stripes can support the notion of making life better for our children and grandchildren. Gale provides a plan to make the economy and nation stronger, one that controls entitlement spending but preserves and enhances their anti-poverty and social insurance roles, increases public investments on human and physical capital, and raises and reforms taxes to pay for government services in a fair and efficient way. What is needed, he argues, is to balance today's needs against tomorrow's obligations. We face significant fiscal challenges but, if we are wise enough to seize our opportunities, we can strengthen our economy, increase opportunity, reduce inequality, and build better lives for our children and grandchildren. We do not have to kill popular programs or starve government. Indeed, one main goal of fiscal reform is to maintain the vital functions that government provides. We need to act responsibly, pay for the government we want, and shape that government in ways that serve us best.
Today, more American women than ever before stay in the workforce into their sixties and seventies. This trend emerged in the 1980s, and has persisted during the past three decades, despite substantial changes in macroeconomic conditions. Why is this so? Today’s older American women work full-time jobs at greater rates than women in other developed countries. In Women Working Longer, editors Claudia Goldin and Lawrence F. Katz assemble new research that presents fresh insights on the phenomenon of working longer. Their findings suggest that education and work experience earlier in life are connected to women’s later-in-life work. Other contributors to the volume investigate additional factors that may play a role in late-life labor supply, such as marital disruption, household finances, and access to retirement benefits. A pioneering study of recent trends in older women’s labor force participation, this collection offers insights valuable to a wide array of social scientists, employers, and policy makers.
A Documentary History tells the story of the creation and development of the U.S. Social Security program through primary source documents, from its antecendents and founding in 1935, to the controversial issues of the present. This unique reference presents the complex history of Social Security in an accessible volume that highlights the program's major moments and events.
In developed countries, men’s labor force participation at older ages has increased in recent years, reversing a decades-long pattern of decline. Participation rates for older women have also been rising. What explains these patterns, and the differences in them across countries? The answers to these questions are pivotal as countries face fiscal and retirement security challenges posed by longer life-spans. This eighth phase of the International Social Security project, which compares the social security and retirement experiences of twelve developed countries, documents trends in participation and employment and explores reasons for the rising participation rates of older workers. The chapters use a common template for analysis, which facilitates comparison of results across countries. Using within-country natural experiments and cross-country comparisons, the researchers study the impact of improving health and education, changes in the occupation mix, the retirement incentives of social security programs, and the emergence of women in the workplace, on labor markets. The findings suggest that social security reforms and other factors such as the movement of women into the labor force have played an important role in labor force participation trends.
Gender equality has been one of the defining projects of European welfarestates. It has proven an elusive goal, not just because of political opposition but also due to a lack of clarity in how to best frame equality and take account of family-related considerations. This wide-ranging book assembles the most pertinent literature and evidence to provide a critical understanding of how contemporary state policies engage with gender inequalities.
Thanks to advances in technology, medicine, Social Security, and Medicare, old age for many Americans is characterized by comfortable retirement, good health, and fulfilling relationships. But there are also millions of people over 65 who struggle with poverty, chronic illness, unsafe housing, social isolation, and mistreatment by their caretakers. What accounts for these disparities among older adults? Sociologist Deborah Carr’s Golden Years? draws insights from multiple disciplines to illuminate the complex ways that socioeconomic status, race, and gender shape the nearly every aspect of older adults’ lives. By focusing on an often-invisible group of vulnerable elders, Golden Years? reveals that disadvantages accumulate across the life course and can diminish the well-being of many. Carr connects research in sociology, psychology, epidemiology, gerontology, and other fields to explore the well-being of older adults. On many indicators of physical health, such as propensity for heart disease or cancer, black seniors fare worse than whites due to lifetimes of exposure to stressors such as economic hardships and racial discrimination and diminished access to health care. In terms of mental health, Carr finds that older women are at higher risk of depression and anxiety than men, yet older men are especially vulnerable to suicide, a result of complex factors including the rigid masculinity expectations placed on this generation of men. Carr finds that older adults’ physical and mental health are also closely associated with their social networks and the neighborhoods in which they live. Even though strong relationships with spouses, families, and friends can moderate some of the health declines associated with aging, women—and especially women of color—are more likely than men to live alone and often cannot afford home health care services, a combination that can be isolating and even fatal. Finally, social inequalities affect the process of dying itself, with white and affluent seniors in a better position to convey their end-of-life preferences and use hospice or palliative care than their disadvantaged peers. Carr cautions that rising economic inequality, the lingering impact of the Great Recession, and escalating rates of obesity and opioid addiction, among other factors, may contribute to even greater disparities between the haves and the have-nots in future cohorts of older adults. She concludes that policies, such as income supplements for the poorest older adults, expanded paid family leave, and universal health care could ameliorate or even reverse some disparities. A comprehensive analysis of the causes and consequences of later-life inequalities, Golden Years? demonstrates the importance of increased awareness, strong public initiatives, and creative community-based programs in ensuring that all Americans have an opportunity to age well.
