The State of Family Caregiving Policy.

As the population ages and supportive services are increasingly delivered in home- and community-based settings, greater demands are placed on family caregivers. This essay introducing the special issue of the Journal of Aging and Social Policy discusses signs of progress on policies to ease the burden on family caregivers. It introduces a series of articles that reflect the growing body of research on caregiver-related policy actions. These actions range from expanding access to paid family leave and payment for providing care, to ensuring access to better data about family caregivers and improving the post- hospital discharge experiences of rural and underserved caregivers. It also explores a major conundrum around caregiving policy - why progress on family caregiving policy has been so slow, despite its clear importance to the health and welfare of those who receive supports, as well as to those providing supports. In addition, the essay discusses developments, such as Biden administration actions and the RAISE Family Caregiver Advisory Council, indicating that the political dynamic around caregiving has changed, concluding that this is a uniquely hopeful time for family caregiver-related policy.

Transitioning to adulthood: Are conventional benchmarks as protective today as they were in the past?

More young adults in the United States are studying beyond high school and working full-time than in the past, yet young adults continue to have high poverty rates as they transition to adulthood. This study uses longitudinal data on two cohorts of young adults from the 1979 and 1997 National Longitudinal Study of Youth to assess whether conventional benchmarks associated with economic success-gaining an education, finding stable employment, and delaying childbirth until after marriage-are as predictive of reduced poverty today as they were in the past. We also explore differences in the protective effect of the benchmarks by race/ethnicity, gender, and poverty status while young. We find that, on average, the benchmarks associated with economic success are as predictive of reduced poverty among young adults today as they were for the prior generation; however, demographics and features of the economy have contributed to higher poverty rates among today's young adults.

Bread or roses? Trade unions, female employment and the expansion of work-family policies.

In the Fordist era, trade unions promoted welfare state expansion and coverage against risks for the broader workforce. With the shift to the post-industrial economy, however, new economic groups have been left without representation. This is particularly evident for women: despite a rapid increase in female employment since the 1980s, unions' membership base remains anchored in the male, old and industrial working class. Without the crucial pressure of labour, welfare systems have failed to enhance the reconciliation of work and family life. Under which conditions do unions support the expansion of work-family policies? Marshalling evidence from 20 OECD countries in the 1980-2010 period, this paper investigates the role of political actors in family policy reform. Findings suggest that unions promote the expansion of work-family packages when they are gender-inclusive and have institutional access to policy-making.

Marital status, State policy environment and Foregone healthcare of same-sex families during the COVID-19 period.

Sexual minorities in the United States have often reported a higher likelihood of forgoing healthcare than heterosexuals, but whether this occurred during the COVID-19 pandemic remains underexplored. This study applies and extends the Andersen model to examine different-sex and same-sex families' likelihood of forgoing healthcare during the pandemic using nationally representative data from the 2020 (May-October) Current Population Survey (N = 139,636). Results are that during the early stage of the pandemic (1) same-sex families overall are more likely than different-sex families to forgo medical care, (2) cohabitating same-sex families were less likely to forgo healthcare than their married counterparts, and (3) state policy environments will moderate only some of the differences in healthcare utilization by family types. Findings provide partial support for hypotheses and suggest a more careful consideration of the role of partnership and state policy in the Andersen model. Policy implications are also discussed.

Evaluation of Active Labor Market Policy Reform: Employment Outcomes of Vocational Rehabilitation Services.

PURPOSE: The purpose of this study is to examine the effect of the Estonian active labor market reform in 2016, which introduced a new policy concerning vocational rehabilitation services. As a research question, we investigate how such services may have affected the employment outcomes of people with mental and/or physical impairments. METHODS: Our sample includes 9244 people from 2016 to 2020, with a mean age of 46 years. Due to multiple entries to the services, we have more than 11,000 cases with over 100,000 monthly observations. We use propensity score matching in combination with fixed effects panel regressions to analyze how the completion of the scheduled rehabilitation plan affected monthly employment duration. RESULTS: Our findings indicate that completing the rehabilitation service results on average in 2.6 months longer post-rehabilitation employment, compared to matched individuals who discontinued the service. This effect was larger when already employed and male participants entered the service, while weaker effects were observed in the case of individuals with only mental disabilities. CONCLUSIONS: Overall, we conclude that while completing the scheduled rehabilitation plan has a positive effect on employment outcomes, still maintaining employment status seems to remain a challenge, based on the relatively modest effect sizes. Thus, we question the economic arguments behind the reform.

Perpetration-Focused Prevention: The Perceptions of Victim-Survivors.

Policymakers are increasingly calling on victim-survivors of child sexual abuse to consult on prevention initiatives, including perpetration-focused prevention efforts like Stop it Now! However, very little is known about the perspectives of victim-survivors on perpetration-focused prevention and whether they support such initiatives. This study was informed by the research question: How do victim-survivors of child sexual abuse perceive perpetration-focused prevention, including the Stop it Now! program? Sixteen Australian victim-survivors participated in an individual, one-hour interview and the data were analysed according to thematic analysis. Four themes emerged through the data analysis: Core of repulsion; Doubt and dismissal; Conditions for congruence; and Arriving at acceptability. These themes are represented as a spiral from the first theme at the centre to the last at the outer edge, reflecting a process of rationalisation. Their initial reaction was a sense of revulsion to perpetration-focused prevention, but their final position was one of conditional support.

Debate: Social media content moderation may do more harm than good for youth mental health.

Most social media platforms censor and moderate content related to mental illness to protect users from harm, though this may be at the expense of potential positive outcomes for youth mental health. Current evidence does not offer strong support for the relationship between censoring mental health content and preventing harm. In fact, existing moderation strategies can perpetuate negative consequences for mental health by creating isolated and polarized communities where at-risk youth remain exposed to harmful content, such as pro-eating disorder communities that use lexical variants to evade censorship. Social media censorship of content related to mental illness can also silence positive discourse about mental health, create barriers to accessing online support and resources, and hinder research efforts on youth well-being. Social media content about mental health can have important positive impacts on youth mental health by facilitating help-seeking, depicting positive coping strategies, and promoting a sense of belonging for struggling youth, but these benefits are minimized under existing moderation and censorship practices. This article presents a call to action for evidence-based social media policies and for practitioners to consider the clinical implications of social media engagement when connecting with young patients.

Understanding food insecurity risk in the United States: A longitudinal analysis.

Background: Food insecurity, lack of consistent access to the food needed for an active, healthy life, harms population health. Although substantial biomedical evidence examines the connections between food insecurity and health, fewer studies examine why food insecurity occurs. Methods: We propose a conceptual understanding of food insecurity risk based on institutions that distribute income-the factor payment system (income distribution stemming from paid labor and asset ownership), transfers within households, and the government tax-and-transfer system. A key feature of our understanding is 'roles' individuals inhabit in relation to the factor payment system: child, older adult, disabled working-age adult, student, unemployed individual, caregiver, or paid laborer. A second feature is that the roles of others in an individual's household also affect an individual's food insecurity risk. We tested hypotheses implied by this understanding, particularly hypotheses relating to role, household composition, and income support programs, using nationally-representative, longitudinal U.S. Current Population Survey data (2016-2019). Results: There were 16,884 participants (year 1 food insecurity prevalence: 10.0%). Inhabiting roles of child (Relative Risk [RR] 1.79, 95% Confidence Interval [95%CI] 1.67 to 1.93), disabled working age-adult (RR 3.74, 95%CI 3.25 to 4.31), or unemployed individual (RR 3.29, 95%CI 2.51 to 4.33) were associated with a greater risk of food insecurity than being a paid laborer. Most food insecure households, 74.8%, had members inhabiting roles of child or disabled working age-adult, and/or contained individuals who experienced job loss. Similar associations held when examining those transitioning from food insecurity to food security in year 2. Conclusions: The proposed understanding accords with the pattern of food insecurity risk observed in the U.S. An implication is that transfer income programs for individuals inhabiting roles, such as childhood and disability, that limit factor payment system participation may reduce food insecurity risk for both those individuals and those in their household.

Reflection on the application of the Consolidated Framework for Implementation Research to a national policy to improve inclusion of people with disabilities.

People with disabilities face many barriers in the built environment impacting their mobility, health, and social participation. In the US, under the Americans with Disabilities Act (ADA), municipalities were required to develop and implement barrier-removal plans for pedestrian infrastructure, called ADA transition plans, but very few have done so. Many communities know they need a plan but do not know how to get it done because of a lack of understanding of the many different implementation considerations. Implementation science offers a useful approach for understanding complex policy implementation such as ADA plans. This paper provides a reflection on the adaptation of the Consolidated Framework for Implementation Research (CFIR) to evaluate the implementation of ADA transition planning. To apply the CFIR, we tailored the construct definitions and modified them to fit the specific context of the ADA transition planning process. We documented the constructs that were more challenging to apply, those that were not relevant, and those that were particularly useful. This paper can serve as a valuable example that other researchers can use when considering adapting the CFIR or other implementation frameworks for the evaluation of complex social policy beyond the ADA.

Darkweb research: Past, present, and future trends and mapping to sustainable development goals.

The Darkweb, part of the deep web, can be accessed only through specialized computer software and used for illegal activities such as cybercrime, drug trafficking, and exploitation. Technological advancements like Tor, bitcoin, and cryptocurrencies allow criminals to carry out these activities anonymously, leading to increased use of the Darkweb. At the same time, computers have become an integral part of our daily lives, shaping our behavior, and influencing how we interact with each other and the world. This work carries out the bibliometric study on the research conducted on Darkweb over the last decade. The findings illustrate that most research on Darkweb can be clustered into four areas based on keyword co-occurrence analysis: (i) network security, malware, and cyber-attacks, (ii) cybercrime, data privacy, and cryptography, (iii) machine learning, social media, and artificial intelligence, and (iv) drug trafficking, cryptomarket. National Science Foundation from the United States is the top funder. Darkweb activities interfere with the Sustainable Development Goals (SDG) laid forth by the United Nations to promote peace and sustainability for current and future generations. SDG 16 (Peace, Justice, and Strong Institutions) has the highest number of publications and citations but has an inverse relationship with Darkweb, as the latter undermines the former. This study highlights the need for further research in bitcoin, blockchain, IoT, NLP, cryptocurrencies, phishing and cybercrime, botnets and malware, digital forensics, and electronic crime countermeasures about the Darkweb. The study further elucidates the multi-dimensional nature of the Darkweb, emphasizing the intricate relationship between technology, psychology, and geopolitics. This comprehensive understanding serves as a cornerstone for evolving effective countermeasures and calls for an interdisciplinary research approach. The study also delves into the psychological motivations driving individuals towards illegal activities on the Darkweb, highlighting the urgency for targeted interventions to promote pro-social online behavior.

The Relationship Between State Level Policy, Insurance and Health Care Engagement for LGBTQ+ Foster Alumni.

Minority stress theory posits that external environmental factors such as state level policies around equity and inclusion of LGBTQ+ people can have a significant impact on the health and wellness of those identifying as part of the larger LGBTQ+ community, as well as on their decisions to seek needed physical or mental health care. This secondary data analysis explored the relationship between state level policies related to LGBTQ+ equity and inclusion and physical and mental health care engagement for foster care alumni. Using data from the Jim Casey Opportunity Passport Survey (n = 2,420), the research team conducted a longitudinal analysis of youth's engagement with healthcare professional as needed physical and mental health care, using sociodemographic characteristics of the respondents and state level policies, such as Medicaid expansion and state level protections for LGBTQ+ citizens as predictors. Results indicate obtaining health insurance increased the likelihood that the youth would seek physical health care. LGBTQ+ young adults assigned female at birth had higher odds of not receiving physical health care relative to non-LGBTQ+ peers. Compared with non-LGBTQ+ youth, LGBTQ+ youth showed higher odds of not seeing mental health professionals when they needed to. Implications for practice, policy and advocacy are presented.

Food Insecurity and Social Policy: A Comparative Analysis of Welfare State Regimes in 19 Countries.

We sought to determine whether a country's social policy configuration-its welfare state regime-is associated with food insecurity risk. We conducted a cross-sectional study of 2017 U.N. Food and Agriculture Organization individual-level food insecurity survey data from 19 countries (the most recent data available prior to COVID-19). Countries were categorized into three welfare state regimes: liberal (e.g., the United States), corporatist (e.g., Germany), or social democratic (e.g., Norway). Food insecurity probability, calibrated to an international reference standard, was calculated using a Rasch model. We used linear regression to compare food insecurity probability across regime types, adjusting for per-capita gross domestic product, age, gender, education, and household composition. There were 19,008 participants. The mean food insecurity probability was 0.067 (SD: 0.217). In adjusted analyses and compared with liberal regimes, food insecurity probability was lower in corporatist (risk difference: -0.039, 95% CI -0.066 to -0.011, p = .006) and social democratic regimes (risk difference: -0.037, 95% CI -0.062 to -0.012, p = .004). Social policy configuration is strongly associated with food insecurity risk. Social policy changes may help lower food insecurity risk in countries with high risk.

Multisector Collaboration vs. Social Democracy for Addressing Social Determinants of Health.

Policy Points Multisector collaboration, the dominant approach for responding to health harms created by adverse social conditions, involves collaboration among health care insurers, health care systems, and social services organizations. Social democracy, an underused alternative, seeks to use government policy to shape the civil (e.g., civil rights), political (e.g., voting rights), and economic (e.g., labor market institutions, property rights, and the tax-and-transfer system) institutions that produce health. Multisector collaboration may not achieve its goals, both because the collaborations are difficult to accomplish and because it does not seek to transform social conditions, only to mitigate their harms. Social democracy requires political contestation but has greater potential to improve population health and health equity.

The Effect of the Earned Income Tax Credit on Physical and Mental health-Results from the Atlanta Paycheck Plus Experiment.

Policy Points The Paycheck Plus randomized controlled trial tested a fourfold increase in the Earned Income Tax Credit (EITC) for single adults without dependent children over 3 years in New York and Atlanta. In New York, the intervention improved economic, mental, and physical health outcomes. In Atlanta, it had no economic benefit or impact on physical health and may have worsened mental health. In Atlanta, tax filing and bonus receipt were lower than in the New York arm of the trial, which may explain the lack of economic benefits. Lower mental health scores in the treatment group were driven by disadvantaged men, and the study sample was in good mental health.

A Missing Piece? Men and the Puzzle of Gender Mainstreaming in the European Union.

In its early uptake and sweeping application of gender mainstreaming, the European Union (EU) sits in the vanguard. However, bringing a gender perspective to bear on policy has proven a stubborn challenge. Drawing on Bacchi's "What's the Problem Represented to Be?" approach and her conceptualization of policies as gendering practices, I critically interrogate how men have been implicated in the problem of gender inequality via policy discourse in the EU. I focus on violence against women/gender-based violence and gender inequalities in education. Analysis of these two issues serves to highlight some of the interpretive limits to the problem of gender inequality in the EU and likely beyond. The discursive elusiveness of men works to keep much of the workings of gender power obscured. Such discounting of "the man question" signals a significant misstep that undercuts gender mainstreaming's transformative prospects.

Taxing reproduction: the full transfer cost of rearing children in Europe.

What are the intergenerational resource transfer contributions of parents and non-parents in Europe? Using National Transfer Accounts and National Time Transfer Accounts for 12 countries around 2010, we go beyond public transfers (net taxes) to also value two statistically much less visible transfers in the family realm: of market goods and of unpaid household labour (time). Non-parents contribute almost exclusively to public transfers. But parents additionally provide still larger private transfers: mothers mainly time, fathers mainly market goods. Estimating transfer stocks over the working life, the average parental/non-parental contribution ratio in Europe flips from 0.73 (public transfers alone) to 2.66 (all three transfers combined). The highest combined parental/non-parental contribution ratios are in Sweden and Finland. The metaphorical tax rates implicitly imposed thereby on rearing children in Europe are multiples of the value-added tax rates in place on consumption goods. Unveiling the sheer magnitude of these invisible transfer asymmetries carries multiple implications for policy debates. For instance, it raises the question whether ageing European societies unwittingly tax, rather than subsidise, their own reproduction. Family friendly policy models, such as the Nordic welfare states, do not mitigate this effect. They help parents work, but do not lower the implicit tax parents pay.

[Passporting of parents of disabled children as an analytical resource of social policy].

The article presents the results of a study of the main social and household characteristics of families with disabled children, conducted in the territory of the Belgorod region (targeted survey; n = 990). The research made it possible to answer questions about children's health problems, their living conditions, the economic status of the family, the work of parents, the social environment and other characteristics of families. The article examines the passporting method of target problem (socially vulnerable) groups as an effective way of obtaining system information, a social picture of the situation, conditions, and problems of such families. The results of the research made it possible to determine the risks associated with the condition of children who require constant help and support, the category of families with unsatisfactory living conditions, the need for advanced training and retraining among parents. An important result of the study was the income map of families with disabled children, which identified the problematic characteristics of the socially vulnerable group and helped determine the directions of primary assistance and support. The scientific result of the article is the conclusion about the need for systematic control of all problematic components of the life of families raising disabled children, about the need for monitoring such information for the organization of targeted assistance and changes in social policy to meet the actual needs of such families.

Making un/equal: reassessing inequality and mental health through a praxeographic approach on welfare categorization processes.

PURPOSE: In recent decades, Europe has seen a steady increase in psychiatric diagnoses, which, besides affecting the population in many ways, also challenges the organization of welfare. This paper explores how welfare classification processes impact the contemporary production of mental (ill) health and social inequality in the German welfare state. METHODS: Based on comprehensive ethnographic research in the public mental healthcare landscape in Berlin between 2011 and 2017, this paper discusses in detail the case of a mandatory prescription of a psychosocial rehabilitation measure for Ms Reisch, a psychiatric service user and ethnographic research partner. The analysis draws on the methodological approach of praxeography to examine how this case challenges the social determinants of mental health framework and the conceptual work of the sociology of inequality on which the categories of welfare are largely built. RESULTS: The paper highlights the essentializing properties of social categories, whether in the sociology of inequality or in social and mental health policy. It also demonstrates the strength of praxeography to expose how multiple welfare categorization processes shape experiences and events of dis/ability in practice, potentially contradicting the stated intentions of social policy. CONCLUSION: The results suggest that the attachment of categories to people in public welfare needs to be changed to make public administration more flexible to responding to the situated processes that bring about differentiations of equal and unequal in practice. The paper, therefore, encourages social inquiry into the potentialities of a post-categorical social policy framework.

Migration and Migrant Labour in the Gig Economy: An Intervention.

In urban gig economies around the world, platform labour is predominantly migrant labour, yet research on the intersection of the gig economy and labour migration remains scant. Our experience with two action research projects, spanning six cities on four continents, has taught us how platform work impacts the structural vulnerability of migrant workers. This leads us to two claims that should recalibrate the gig economy research agenda. First, we argue that platform labour simultaneously degrades working conditions while offering migrants much-needed opportunities to improve their livelihoods. Second, we contend that the reclassification of gig workers as employees is by itself not sufficient to counter the precarisation of migrant gig work. Instead, we need ambitious policies at the intersection of immigration, social welfare, and employment regulation that push back against the digitally mediated commodification of migrant labour worldwide.

The Potential of Social Policies in Preventing Dementia: An Ecological Study Using Systematic Review and Meta-Analysis.

Social policies determine the distribution of factors (e.g. education, cardiovascular health) protecting against the development of dementia in Alzheimer's disease (AD). However, the association between social policies and the likelihood of AD without dementia (ADw/oD) has yet to be evaluated. We estimated this association in an ecological study using systematic review and meta-analysis. Four reference databases were consulted; 18 studies were included in the final analysis. ADw/oD was defined as death without dementia in people with clinically significant AD brain pathology. The indicators of social policy were extracted from the Organisation for Economic Co-operation and Development database (OECD). The probability of ADw/oD with moderate AD brain pathology was inversely associated with the Gini index for disposable income, poverty rate, and certain public expenditures on healthcare. ADw/oD with advanced AD brain pathology was only associated with public expenditures for long-term care. Social policies may play a role in maintaining and sustaining cognitive health among older people with AD.