Lingering Legacies: Public Attitudes about Medicaid Beneficiaries and Work Requirements.

CONTEXT: This article provides a detailed picture of the mindset of Americans about Medicaid work requirements and the important roles that perception of deservingness and racial bias play in public attitudes. METHODS: The authors conducted a large original survey to investigate public attitudes toward work requirements. They analyzed the predictors of overall support for work requirements, correlates of who should be exempt from them, and attitudes toward work supports that make compliance with work requirements easier. FINDINGS: The authors found that public opinion is split relatively evenly when it comes to Medicaid work requirements in the abstract. When Americans are confronted with the complexities of the issue, important nuances emerge. The authors also found consistent evidence that support for work requirements is higher among conservatives, those who see Medicaid as a short-term program, and racially resentful non-Hispanic whites. They show that groups that have historically been framed as deserving see high levels of support for their exemption (e.g., the disabled and senior citizens). Finally, the authors found that Americans are supportive of policies that provide individuals with help when transitioning into the workforce. CONCLUSIONS: Americans' views of Medicaid and the populations it serves are complex and continue to be influenced by perceptions of deservingness and race.

La pastoral de los cuerpos: pobreza, género y asistencia hospitalaria en Puerto Rico, 1812-1823 / The pastoral of the bodies: poverty, gender, and hospital care in Puerto Rico, 1812-1823

En este artículo se analizan los primeros intentos realizados por el Estado para implementar la beneficencia pública en Puerto Rico. Se argumenta que los liberales lucharon por adelantar sus políticas en favor de la población desposeída, pero que sus acciones se vieron limitadas por las dificultades que encontraron en la Isla, entre ellas la falta de las instituciones de caridad. En los dos primeros periodos constitucionales (1812-1814 y 1820-1823) se intentó actuar en favor de todos los pobres, pero solo se logró atender a los enfermos pobres en los hospitales de la ciudad de San Juan. En el desarrollo del artículo se muestra que durante el siglo XIX importó mucho el género para ingresar a los hospitales: en el primer periodo constitucional solamente se asistieron a los hombres en el Hospital Militar; las mujeres fueron atendidas en el segundo periodo constitucional, cuando el Estado consiguió administrar el Hospital de Pobres. A pesar de la intermitencia entre los proyectos políticos liberales y conservadores, se dieron los primeros pasos para comenzar a asistir a los enfermos puertorriqueños pobres en los hospitales de la ciudad

This article analyses the State's first attempt to implement public assistance in Puerto Rico. It is argued that liberals fought to advance their policies in order to favor the underprivileged population, but that their actions were limited by the difficulties encountered in the island, the lack of charities being one of them. During the first two constitutional periods (1812-1814 and 1820-1823,) an attempt was made to assist all of the underprivileged people, but only the sick at hospitals in the city of San Juan, were able to receive assistance. Throughout the article, it is demonstrated that during the XIX Century, gender played an important role when being admitted to a hospital: during the first constitutional period, only males received assistance at the Military Hospital; women received assistance during the second constitutional period, once the State was able to oversee the Hospital for the Underprivileged. In spite of the intermittence between the liberal and conservative political policies, the first steps to begin assisting sick and underprivileged Puerto Ricans in the city's hospitals were given

Between resentment and aid: German and Austrian psychiatrist and neurologist refugees in Great Britain since 1933.

This article is a historiographical exploration of the experiences that German and Austrian émigré psychiatrists and neurologists made in Great Britain since 1933, after the Nazi Governments in Central Europe had ousted them from their positions. When placing these occurrences in a wider historiographical perspective, the in-depth analysis provided here also describes the living and working conditions of the refugee neuroscientists on the British Isles. In particular, it looks at the very elements and issues that influenced the international forced migration of physicians and psychiatrists during the 1930s and 1940s. Only a fraction of refugee neuroscientists had however been admitted to Britain. Those lucky ones were assisted by a number of charitable, local, and academic organizations. This article investigates the rather lethargic attitude of the British government and medical circles towards German-speaking Jewish refugee neuroscientists who wished to escape Nazi Germany. It will also analyze the help that those refugees received from the academic establishment and British Jewish organizations, while likewise examining the level and extent of the relationship between social and scientific resentments in Great Britain. A special consideration will be given to the aid programs that had already began in the first year after the Nazis had seized power in Germany, with the foundation of the British Assistance Council by Sir William Henry Beveridge (1879-1963) in 1933.

La economía política de los hospitales locales en la Cataluña moderna / The political economy of local hospitals in Catalonia during the modern age

Los hospitales, en Cataluña, se inscribieron desde la Baja Edad Media hasta nuestros días dentro un modelo de gobierno específico que dio lugar a la creación y mantenimiento de una densa red de instituciones asistenciales en prácticamente todos los municipios, incluso en los más pequeños, cuyo marco legal fue el derecho privado o civil. Dicho modelo tiene sus fundamentos, en primer lugar, en la constatación de cómo los individuos legaban al hospital no sólo por la filantropía o caridad, sino también por la necesidad de aportar algo a la comunidad después de su muerte, en una suerte de consigna con el fin de devolver parte de los activos que los testadores habían acumulado durante su vida como instrumento para asegurar la reproducción social de la comunidad. En segundo lugar, se observa que las pequeñas instituciones privadas locales se fusionaron con los hospitales municipales, no así sus activos que continuaron gestionandose por separado de los de la ciudad. En tercer lugar, además de la función de cuidado, el hospital era también un agente económico que operaba de manera similar a los «Monte dei Paschi» italianos. Por consiguiente, el significado de la institución resultó ser más complejo que la simple prestación de servicios asistenciales. Adquirió un valor específico en la identidad de la comunidad, se convirtió en uno de los centros de debate en la vida pública y adquirió un significado económico y financiero que contribuyó a fortalecer la construcción de la identidad colectiva de los ciudadanos (AU)

The aim of this paper is to highlight how hospitals, in Catalonia since the late Middle Ages to the currently, adopted a governance model which resulted in the creation and preservation of hospitals or care institutions in virtually all municipalities, even in small, whose frame legal was the private or civil law. Firstly, we observed how individuals were motivated not only by philanthropy or charity, but also by a need to contribute something to the community after their death, to give back part of the assets the testators had accumulated during their lifetimes, as citizens who had benefited from their positions. Secondly, we observed that the small local private institutions merged with municipal hospitals, but that their assets were managed separately from those of the town. Third, as well as its care function, the hospital was also an economic agent that operated along similar lines to the Italian «Monte dei Paschi». It provided loans to working class citizens at a modest rate of interest. The meaning of the institution was found to be more complex than the simple provision of care services. It acquired a specific value in the identity of the community, it became one of the centers of debate in public life and it took on an economic and financial meaning that strengthened the construction of the citizens’ collective identity (AU)

[The assistance of the Portuguese Colony of Brazil, 1918-1973]. / A assistência da Colónia Portuguesa do Brasil, 1918-1973.

This article seeks to redeem the historical memory of a health institution in Portugal which reconfigured itself and adapted to the social and medical needs and concerns during the twentieth century. The trajectory of this institution contributes to the history of Portuguese medicine and to the history of the philanthropy of the Portuguese colony resident in Brazil and the so called "Brazilians" that returned to Portugal, whose remittances provided the means to set up a benchmark health institution in the twenty-first century. The methodology was based on archival research in Portugal (Coimbra, Bissaya Barreto Foundation) and in Brazil (Rio de Janeiro, Real Gabinete Português de Leitura) and the cross-checking of these primary sources with due historical and social contextualization.

A Assistência da Colónia Portuguesa do Brasil, 1918-1973 / The Assistance of the Portuguese Colony of Brazil, 1918-1973

Este artigo pretende resgatar a memória histórica de uma instituição de saúde em Portugal que se reconfigurou e adaptou às necessidades e preocupações sociais e médicas no decorrer do século XX. Traçar o percurso desta instituição contribui para a história da medicina portuguesa e, ao mesmo tempo, para a história da filantropia da colónia portuguesa radicada no Brasil e dos “brasileiros de torna viagem” que, pelas suas remessas financeiras, tornaram possível uma instituição de saúde de referência no século XXI. A metodologia seguida nesta investigação assentou na pesquisa de arquivo em Portugal (Coimbra, Fundação Bissaya Barreto) e no Brasil (Rio de Janeiro, Real Gabinete Português de Leitura) e no cruzamento destas fontes primárias com a devida contextualização histórica e social.

This article seeks to redeem the historical memory of a health institution in Portugal which reconfigured itself and adapted to the social and medical needs and concerns during the twentieth century. The trajectory of this institution contributes to the history of Portuguese medicine and to the history of the philanthropy of the Portuguese colony resident in Brazil and the so called “Brazilians” that returned to Portugal, whose remittances provided the means to set up a benchmark health institution in the twenty-first century. The methodology was based on archival research in Portugal (Coimbra, Bissaya Barreto Foundation) and in Brazil (Rio de Janeiro, Real Gabinete Português de Leitura) and the cross-checking of these primary sources with due historical and social contextualization.

Perception of insecurity in French poor neighbourhoods: racial proxy or pure discrimination hypotheses?

Many poor neighbourhoods, home to both socially disadvantaged populations and to foreigners, are characterised by a strong perception of insecurity. The purpose of this article is determine the origin of this perception. To do so, two possible causes are dissociated: racial prejudice and racial proxy (the ethnic minorities are perceived in terms of the negative social characteristics that are often associated with them). More specifically, it is shown that the 'ethnic' variable captures the effects of an overconcentration of poverty, approximated here by the concentration of unemployment, but that these two variables act separately. This result should be taken into account in the policies implemented by public authorities and local actors. In this study, an original methodology is applied based simultaneously on individual geocoded data, the proportion of foreigners, the unemployment rate at the neighbourhood level and an indirect indicator of perceived insecurity.

Social welfare as small-scale help: evolutionary psychology and the deservingness heuristic.

Public opinion concerning social welfare is largely driven by perceptions of recipient deservingness. Extant research has argued that this heuristic is learned from a variety of cultural, institutional, and ideological sources. The present article provides evidence supporting a different view: that the deservingness heuristic is rooted in psychological categories that evolved over the course of human evolution to regulate small-scale exchanges of help. To test predictions made on the basis of this view, a method designed to measure social categorization is embedded in nationally representative surveys conducted in different countries. Across the national- and individual-level differences that extant research has used to explain the heuristic, people categorize welfare recipients on the basis of whether they are lazy or unlucky. This mode of categorization furthermore induces people to think about large-scale welfare politics as its presumed ancestral equivalent: small-scale help giving. The general implications for research on heuristics are discussed.

Welfare policymaking and intersections of race, ethnicity, and gender in U.S. state legislatures.

Welfare policy in the American states has been shaped profoundly by race, ethnicity, and representation. Does gender matter as well? Focusing on state welfare reform in the mid-1990s, we test hypotheses derived from two alternative approaches to incorporating gender into the study of representation and welfare policymaking. An additive approach, which assumes gender and race/ethnicity are distinct and independent, suggests that female state legislators­regardless of race/ethnicity­will mitigate the more restrictive and punitive aspects of welfare reform, much like their African American and Latino counterparts do. In contrast, an intersectional approach, which highlights the overlapping and interdependent nature of gender and race/ethnicity, suggests that legislative women of color will have the strongest countervailing effect on state welfare reform­stronger than that of other women or men of color. Our empirical analyses suggest an intersectional approach yields a more accurate understanding of gender, race/ethnicity, and welfare politics in the states.

Creating an enabling environment for diasporas' participation in homeland development.

Diasporas contribute to their homeland's development through remittances, philanthropy, skills transfer, business investment, and advocacy. This paper focuses on actions that homeland governments can take to create an enabling environment for diasporas' contributions. Part I addresses the diaspora phenomenon and the homeland government-diaspora relationship. Part II develops a framework for characterizing government's role in an enabling environment specific to diasporas' development contributions. Part III considers how to put the framework into practice, identifying important caveats and discussing several implementation issues, including the potential role of donors. The framework is also a tool for diasporans to strategically advocate for improved enabling environments.

Rural income transfer programs and rural household food security in Ethiopia.

Based on household food security surveys conducted in Ethiopia, this study seeks to understand the roles and limitations of income transfer projects as determinants of households' food security. By covering the Food-For-Work Programs (FFWPs) and the Productive Safety Net Programs (PSNPs), the study shows that these programs served as temporary safety nets for food availability, but they were limited in boosting the dietary diversity of households and their coping strategies. Households which participated in the programs increased their supply of food as a temporary buffer to seasonal asset depletion. However, participation in the programs was marred by inclusion error (food-secure households were included) and exclusion error (food-insecure households were excluded). Income transfer projects alone were not robust determinants of household food security. Rather, socio-demographic variables of education and family size as well as agricultural input of land size were found to be significant in accounting for changes in households' food security. The programs in the research sites were funded through foreign aid, and the findings of the study imply the need to reexamine the approaches adopted by bilateral donors in allocating aid to Ethiopia. At the same time the study underscores the need to improve domestic policy framework in terms of engendering rural local institutional participation in project management.

Who benefits from child benefit?

Governments, over much of the developed world, make significant financial transfers to parents with dependent children. For example, in the United States the recently introduced Child Tax Credit (CTC), which goes to almost all children, costs almost $1 billion each week, or about 0.4% of GNP. The United Kingdom has even more generous transfers and spends an average of about $30 a week on each of about 8 million children­about 1% of GNP. The typical rationale given for these transfers is that they are good for our children and here we investigate the effect of such transfers on household spending patterns. In the United Kingdom such transfers, known as Child Benefit (CB), have been simple lump sum universal payments for a continuous period of more than 20 years. We do indeed find that CB is spent differently from other income­paradoxically, it appears to be spent disproportionately on adult-assignable goods. In fact, we estimate that as much as half of a marginal dollar of CB is spent on alcohol. We resolve this puzzle by showing that the effect is confined to unanticipated variation in CB so we infer that parents are sufficiently altruistic toward their children that they completely insure them against shocks.

Belonging and community: understandings of "home" and "friends" among the English poor, 1750-1850.

This article is based on unique 'narratives of the poor', that is, letters from poor people to their parishes of settlement, petitions to the London Refuge of the Destitute, and letters from mothers to the London Foundling Hospital, with supportive evidence from newspapers. These display fundamental concepts among the English poor, who were often poorly literate, and who comprised the majority of the population. Discussion focuses upon their understandings of 'home', 'belonging', 'friends', and 'community'. These key concepts are related here to modern discussions, to set important concerns into historical perspective. 'Friends', valuably studied by sociologists such as Pahl, had a wide meaning in the past. 'Home' meant (alongside abode) one's parish of legal settlement, where one was entitled to poor relief under the settlement/poor laws. This was where one 'belonged'. Ideas of 'community' were held and displayed even at a distance, among frequently migrant poor, who wrote to their parishes showing strong ties of attachment, right, and local obligation. This discussion explores these issues in connection with belonging and identity. It elucidates the meaning and working of poor law settlement, and is also an exploration of popular mentalities and the semi-literate ways in which these were expressed.

Los indigentes ante la asistencia pública: una estrategia para sobrevivir en la ciudad de México, 1877-1905 / The indigents before the public assistance: a strategy to survive in Mexico city, 1877-1905

Este artículo se ocupa de un grupo escasamente estudiado en la historiografía mexicana: los pobres urbanos. Con un enfoque novedoso, los indigentes no son sólo el objeto de las políticas públicas y de las instituciones, sino que se consideran actores sociales que concretan reformas y definen prácticas de la asistencia porfiriana. Si bien los recursos de la beneficencia son limitados, el ingreso en las instituciones de auxilio público es una alternativa de subsistencia para los indigentes de la ciudad. Su determinación por ingresar en el Tecpam de Santiago y en el Hospicio de Pobres se manifiesta en las solicitudes, al presentarse como merecedores ideales de la asistencia . Esta ayuda se demanda y se defiende con reclamos ocultos y manifestaciones expresas, pues por la costumbre de recibir el socorro del Estado la beneficencia es un instrumento para ganarse la vida. (AU)

The Bruce Report and social welfare leadership in the politics of Toronto's "Slums", 1934­1939.

Slum clearance and rebuilding first became a serious political project in Toronto during the 1930s. Following the release of a systematic housing survey known as the Bruce Report (1934), a set of actors distinguished by their planning authority with respect to social agencies, influence over social work education, coordination of social research, and role as spokespersons of religious bodies inaugurated a political struggle over state power. While the campaign failed, it called forth a reaction from established authorities and reconfigured the local political field as it related to low-income housing. This article gives an account of these processes by drawing upon correspondence and minutes of meetings of city officials and the campaign's organizers, newspaper clippings, and published materials.