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| Author | : National Research Council |
| Publisher | : National Academies Press |
| Total Pages | : 71 |
| Release | : 1998-04-11 |
| Genre | : Social Science |
| ISBN | : 0309060400 |
| Author | : National Research Council |
| Publisher | : National Academies Press |
| Total Pages | : 72 |
| Release | : 1998-03-11 |
| Genre | : Social Science |
| ISBN | : 9780309075152 |
| Author | : National Research Council |
| Publisher | : National Academies Press |
| Total Pages | : 159 |
| Release | : 1999-11-04 |
| Genre | : Social Science |
| ISBN | : 0309184118 |
The Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996 fundamentally changed the nation's social welfare system, replacing a federal entitlement program for low-income families, called Aid to Families with Dependent Children (AFDC), with state-administered block grants, the Temporary Assistance for Needy Families (TANF) program. PRWORA furthered a trend started earlier in the decade under so called "waiver" programs-state experiments with different types of AFDC rules-toward devolution of design and control of social welfare programs from the federal government to the states. The legislation imposed several new, major requirements on state use of federal welfare funds but otherwise freed states to reconfigure their programs as they want. The underlying goal of the legislation is to decrease dependence on welfare and increase the self-sufficiency of poor families in the United States. In summer 1998, the Office of the Assistant Secretary for Planning and Evaluation (ASPE) of the Department of Health and Human Services (DHHS) asked the Committee on National Statistics of the National Research Council to convene a Panel on Data and Methods for Measuring the Effects of Changes in Social Welfare Programs. The panel's overall charge is to study and make recommendations on the best strategies for evaluating the effects of PRWORA and other welfare reforms and to make recommendations on data needs for conducting useful evaluations. This interim report presents the panel's initial conclusions and recommendations. Given the short length of time the panel has been in existence, this report necessarily treats many issues in much less depth than they will be treated in the final report. The report has an immediate short-run goal of providing DHHS-ASPE with recommendations regarding some of its current projects, particularly those recently funded to study "welfare leavers"-former welfare recipients who have left the welfare rolls as part of the recent decline in welfare caseloads.
| Author | : National Academies of Sciences, Engineering, and Medicine |
| Publisher | : National Academies Press |
| Total Pages | : 583 |
| Release | : 2017-04-27 |
| Genre | : Medical |
| ISBN | : 0309452961 |
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.
| Author | : Committee for the Study of the Future of Public Health |
| Publisher | : National Academies Press |
| Total Pages | : 240 |
| Release | : 1988-01-15 |
| Genre | : Medical |
| ISBN | : 0309581907 |
"The Nation has lost sight of its public health goals and has allowed the system of public health to fall into 'disarray'," from The Future of Public Health. This startling book contains proposals for ensuring that public health service programs are efficient and effective enough to deal not only with the topics of today, but also with those of tomorrow. In addition, the authors make recommendations for core functions in public health assessment, policy development, and service assurances, and identify the level of government--federal, state, and local--at which these functions would best be handled.
| Author | : Alan Weil |
| Publisher | : The Urban Insitute |
| Total Pages | : 448 |
| Release | : 2003 |
| Genre | : Business & Economics |
| ISBN | : 9780877667162 |
The balance between state and federal health care financing for low-income people has been a matter of considerable debate for the last 40 years. Some argue for a greater federal role, others for more devolution of responsibility to the states. Medicaid, the backbone of the system, has been plagued by an array of problems that have made it unpopular and difficult to use to extend health care coverage. In recent years, waivers have given the states the flexibility to change many features of their Medicaid programs; moreover, the states have considerable flexibility to in establishing State Children's Health Insurance Programs. This book examines the record on the changing health safety net. How well have states done in providing acute and long-term care services to low-income populations? How have they responded to financial incentives and federal regulatory requirements? How innovative have they been? Contributing authors include Donald J. Boyd, Randall R. Bovbjerg, Teresa A. Coughlin, Ian Hill, Michael Housman, Robert E. Hurley, Marilyn Moon, Mary Beth Pohl, Jane Tilly, and Stephen Zuckerman.
| Author | : National Research Council |
| Publisher | : National Academies Press |
| Total Pages | : 200 |
| Release | : 2011-06-27 |
| Genre | : Social Science |
| ISBN | : 0309217105 |
During the last 25 years, life expectancy at age 50 in the United States has been rising, but at a slower pace than in many other high-income countries, such as Japan and Australia. This difference is particularly notable given that the United States spends more on health care than any other nation. Concerned about this divergence, the National Institute on Aging asked the National Research Council to examine evidence on its possible causes. According to Explaining Divergent Levels of Longevity in High-Income Countries, the nation's history of heavy smoking is a major reason why lifespans in the United States fall short of those in many other high-income nations. Evidence suggests that current obesity levels play a substantial part as well. The book reports that lack of universal access to health care in the U.S. also has increased mortality and reduced life expectancy, though this is a less significant factor for those over age 65 because of Medicare access. For the main causes of death at older ages-cancer and cardiovascular disease-available indicators do not suggest that the U.S. health care system is failing to prevent deaths that would be averted elsewhere. In fact, cancer detection and survival appear to be better in the U.S. than in most other high-income nations, and survival rates following a heart attack also are favorable. Explaining Divergent Levels of Longevity in High-Income Countries identifies many gaps in research. For instance, while lung cancer deaths are a reliable marker of the damage from smoking, no clear-cut marker exists for obesity, physical inactivity, social integration, or other risks considered in this book. Moreover, evaluation of these risk factors is based on observational studies, which-unlike randomized controlled trials-are subject to many biases.
| Author | : Institute of Medicine |
| Publisher | : National Academies Press |
| Total Pages | : 202 |
| Release | : 2008-09-06 |
| Genre | : Medical |
| ISBN | : 0309113695 |
Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.
| Author | : National Academies of Sciences, Engineering, and Medicine |
| Publisher | : National Academies Press |
| Total Pages | : 619 |
| Release | : 2019-09-16 |
| Genre | : Social Science |
| ISBN | : 0309483980 |
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.
| Author | : National Research Council |
| Publisher | : National Academies Press |
| Total Pages | : 267 |
| Release | : 2001-08-10 |
| Genre | : Social Science |
| ISBN | : 0309171342 |
Reform of welfare is one of the nation's most contentious issues, with debate often driven more by politics than by facts and careful analysis. Evaluating Welfare Reform in an Era of Transition identifies the key policy questions for measuring whether our changing social welfare programs are working, reviews the available studies and research, and recommends the most effective ways to answer those questions. This book discusses the development of welfare policy, including the landmark 1996 federal law that devolved most of the responsibility for welfare policies and their implementation to the states. A thorough analysis of the available research leads to the identification of gaps in what is currently known about the effects of welfare reform. Evaluating Welfare Reform in an Era of Transition specifies what-and why-we need to know about the response of individual states to the federal overhaul of welfare and the effects of the many changes in the nation's welfare laws, policies, and practices. With a clear approach to a variety of issues, Evaluating Welfare Reform in an Era of Transition will be important to policy makers, welfare administrators, researchers, journalists, and advocates on all sides of the issue.
