Unemployment Insurance and Opioid Overdose Mortality in the United States.

Over the past two decades, opioid overdose deaths contributed to the dramatic rise in all-cause mortality among non-Hispanic Whites. To date, efforts among scholars to understand the role of local area labor market conditions on opioid overdose mortality have led to mixed results. We argue the reason for these disparate findings is scholars have not considered the moderating effects of income support policies such as unemployment insurance. The present study leverages two sources of variation-county mass layoffs and changes in the generosity of state unemployment insurance benefits-to investigate if unemployment benefits moderate the relationship between job loss and county opioid overdose death rates. Our difference-in-differences estimation strategy reveals that the harmful effects of job loss on opioid overdose mortality decline with increasing state unemployment insurance benefit levels. These findings suggest that social policy in the form of income transfers played a crucial role in disrupting the link between job loss and opioid overdose mortality.

Narrowing Racial Differences in Trust: How Discrimination Shapes Trust in a Racialized Society.

In the United States, survey research and qualitative studies consistently find that people of color-and Blacks in particular-report substantially lower levels of trust than do whites. These racial differences in trust pervade a range of social contexts, from interpersonal relationships with friends, family, and neighbors to interactions with the health care and criminal justice systems. Scholars often attribute racial differences in trust to historical and contemporary forms of discrimination, yet few studies have assessed the relationship among race, discrimination, and trust in the context of the United States. Using the Chicago Community Adult Health Study, I examine how the experience of discrimination relates to generalized trust, trust in neighbors, and trust in community police. Findings reveal that personal experience with discrimination contributes modestly to racial differences in trust. In fact, the negative association between discrimination and generalized trust appears strongest for whites. These findings suggest that understanding distrust requires a richer conceptual framework that moves beyond personal experience with discrimination. I argue that the theory of systemic racism provides a framework for understanding distrust as a consequence of countervailing efforts to uphold and contest the racial hierarchy.

Child protective services contact and youth outcomes.

BACKGROUND: Few studies have investigated whether Child Protective Services (CPS) contact influences child wellbeing, independent of underlying maltreatment and not considered as a proxy for such maltreatment. OBJECTIVE: The present study estimates the association between CPS contact and child delinquency, education, substance use, and mental health and development. PARTICIPANTS AND SETTING: The study used data from the Fragile Families and Child Wellbeing Study, a longitudinal birth cohort study of children born in 20 US cities. Study outcomes were based on age-15 interviews with the focal children and their caregivers with sample sizes ranging from 2088 to 2327 across outcomes. METHODS: The relationship between CPS contact and child wellbeing was estimated using the propensity score method of inverse probability of treatment weighting. RESULTS: CPS contact was associated with an 88% increase in the probability of smoking (p = .010), a 29 % increase in externalizing behavior (p < .001), a 27% increase in internalizing behavior (p = .001), a 18 % increase in the probability of being expelled (p = .32), a 7.5 % increase in a depression (p = .002), a 6.9 % increase in anxiety (p = .002), a 6.2 % reduction in happiness (p = .008), a 6.0 % increase in impulsivity (p < .001), and a 5.5 % increase in school troubles (p < .001). CONCLUSIONS: Despite a federal mandate to improve child wellbeing, we found no evidence that contact with the child welfare system improves child outcomes. Rather, CPS contact was associated with worse mental health and developmental outcomes.

Emergency unemployment benefits and health care spending during Covid.

OBJECTIVE: To estimate the impact of the $600 per week Federal Pandemic Unemployment Compensation (FPUC) payments on health care services spending during the Covid pandemic and to investigate if this impact varied by state Medicaid expansion status. DATA SOURCES: This study leverages novel, publicly available data from Opportunity Insights capturing consumer credit and debit card spending on health care services for January 18-August 15, 2020 as well as information on unemployment insurance claims, Covid cases, and state policy changes. STUDY DESIGN: Using triple-differences estimation, we leverage two sources of variation-within-state change in the unemployment insurance claims rate and the introduction of FPUC payments-to estimate the moderating effect of FPUC on health care spending losses as unemployment rises. Results are stratified by state Medicaid expansion status. EXTRACTION METHODS: Not applicable. PRINCIPAL FINDINGS: For each percentage point increase in the unemployment insurance claims rate, health care spending declined by 1.0% (<0.05) in Medicaid expansion states and by 2.0% (<0.01) in nonexpansion states. However, FPUC partially mitigated this association, boosting spending by 0.8% (<0.001) and 1.3% (<0.05) in Medicaid expansion and nonexpansion states, respectively, for every percentage point increase in the unemployment insurance claims rate. CONCLUSIONS: We find that FPUC bolstered health care spending during the Covid pandemic, but that both the negative consequences of unemployment and moderating effects of federal income supports were greatest in states that did not adopt Medicaid expansion. These results indicate that emergency federal spending helped to sustain health care spending during a period of rising unemployment. Yet, the effectiveness of this program also suggests possible unmet demand for health care services, particularly in states that did not adopt Medicaid expansion.

Rent Assistance and Health: Findings from Detroit.

This study assesses the relationship between rent assistance and health in a longitudinal, population-representative sample collected in the Detroit metro area. Previous research has found that rent assistance recipients are less healthy than otherwise similar non-recipients in the cross-section, but the evidence about the effects of rent assistance on health in the long run is ambiguous. Our study uses panel survey data to compare the health of recipients and eligible non-recipients at the study's onset and four years later at follow-up with respect to an extensive set of physical, mental, and behavioral health outcomes. Our results demonstrate that rent assistance recipients are in worse overall health than non-recipients, but also provide suggestive evidence that the program may buffer health declines in the medium term. However, the positive buffering effects may be erased in the long run, as we simultaneously observed an increase in smoking among rent assistance recipients. Our study shows that the current shortage of rent assistance may have implications for population health.

Foster home placements and the probability of family reunification: Does licensing matter?

The concept of foster care has been widely studied in child welfare. The literature is well developed with regard to the risk of initial placement, length of stay in care, placement stability, exits to permanency, and emancipation. Yet, the literature is woefully underdeveloped when it comes to understanding if variations in the types and characteristics of foster homes impact important child welfare outcomes. The current study utilizes entry cohorts pulled from statewide administrative data (N=17,960) to investigate the association between types of foster care and the probability of reunification. We focus specifically on the licensing status of foster homes. Reflecting federal benchmarks, we examined the odds of reunification at one- and two-year intervals. Propensity score analysis was used to reduce selection bias. Adjusted logistic regression models revealed that youth placed in licensed relative care (LRC) homes were the least likely to achieve reunification compared with youth placed in licensed non-relative care (LNC) homes and unlicensed relative care (URC) homes. Conversely, youth placed in URC homes were more likely to achieve reunification as compared with youth placed in LRC and LNC homes. These findings will help states to efficiently target scarce resources to specific types of foster homes that may be impacting federal reunification benchmarks.