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The SSRC Library allows visitors to access materials related to self-sufficiency programs, practice and research. Visitors can view common search terms, conduct a keyword search or create a custom search using any combination of the filters at the left side of this page. To conduct a keyword search, type a term or combination of terms into the search box below, select whether you want to search the exact phrase or the words in any order, and click on the blue button to the right of the search box to view relevant results.

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  • Individual Author: Guo, Baorong; Huang, Jin; Porterfield, Shirley L.
    Reference Type: Report
    Year: 2018

    Young adults face enormous economic, social and psychological challenges when they transition into adulthood. This transition can be especially overwhelming and daunting for young adults with disabilities. Among the challenges young adults with disabilities are faced with are greater risk of low food security and barriers to healthcare. This study examines how the transition to adulthood may affect food security, health, and access to healthcare for youth with disabilities, and estimates the effects that SNAP has on this group in those turbulent years.

    The study used five years of data (2011-2015) from the National Health Interview Survey (NHIS). We combined the public and restricted NHIS data with the state SNAP policy variables. The sample included low-income individuals ages 13-25 (and their families) to reflect the life stage from pre-transition, to transition, and then to post-transition. Analyses were conducted at the Census Research Data Center in Columbia, MO. A difference-in-difference (DID) approach in linear models was applied to compare individuals with and...

    Young adults face enormous economic, social and psychological challenges when they transition into adulthood. This transition can be especially overwhelming and daunting for young adults with disabilities. Among the challenges young adults with disabilities are faced with are greater risk of low food security and barriers to healthcare. This study examines how the transition to adulthood may affect food security, health, and access to healthcare for youth with disabilities, and estimates the effects that SNAP has on this group in those turbulent years.

    The study used five years of data (2011-2015) from the National Health Interview Survey (NHIS). We combined the public and restricted NHIS data with the state SNAP policy variables. The sample included low-income individuals ages 13-25 (and their families) to reflect the life stage from pre-transition, to transition, and then to post-transition. Analyses were conducted at the Census Research Data Center in Columbia, MO. A difference-in-difference (DID) approach in linear models was applied to compare individuals with and without disabilities regarding changes in food security status and their health-related outcomes in the transition to adulthood. State SNAP policy variables were used as exogenous instruments to estimate the effects of SNAP participation on food security and health/healthcare use for youth and young adults with disabilities in the models of instrumental variables.

    The study’s limitations are closely examined with a focus on the constraints that we had in the DID analysis and the IV analysis. We also suggested directions for future research. Since food security likely has a profound impact on the long-term development, economic independence, and self-sufficiency, we discussed a few policy strategies that may help individuals with disabilities in their transition to adulthood. These include special outreach services to improve SNAP accessibility, an embedded alert system that serves to bring awareness of a SNAP participant’s upcoming transition to adulthood, incorporation of nutrition assistance in transition planning for youth, and better coordination of multiple public programs. (Author abstract)

  • Individual Author: King Bowes, Kendra; Burrus, Barri B.; Axelson, Sarah; Garrido, Milagros; Kimbriel, Adriana ; Abramson, Lisa; Gorman, Gwenda; Dancer, Angela; White, Terrill; Beaudry, PJ
    Reference Type: Journal Article
    Year: 2018

    Systemic inequities, including a lack of culturally appropriate sexual health education, put American Indian and Alaska Native (AI/AN) adolescents at higher-than-average risk for adverse sexual and reproductive health outcomes. For example, in 2013, the birth rate among AI/AN adolescents aged 15 to 19 years was 31.1 per 1000 individuals, compared with 18.6 for White adolescents. AI/AN youths report earlier onset of sexual activity and greater numbers of sexual partners than do youths in general. In 2011, among all races and ethnicities, AI/ANs had the second highest rates of chlamydia and gonorrhea and the third highest rates of primary and secondary syphilis. From 2011 through 2014, the US Department of Health and Human Services’ Family and Youth Services Bureau, through the Tribal Personal Responsibility Education Program (Tribal PREP), funded 14 tribes and tribal organizations to select, adapt, and implement culturally relevant, evidence-informed contraceptive and abstinence education curricula for their communities. Grantees also promoted successful transitions to adulthood...

    Systemic inequities, including a lack of culturally appropriate sexual health education, put American Indian and Alaska Native (AI/AN) adolescents at higher-than-average risk for adverse sexual and reproductive health outcomes. For example, in 2013, the birth rate among AI/AN adolescents aged 15 to 19 years was 31.1 per 1000 individuals, compared with 18.6 for White adolescents. AI/AN youths report earlier onset of sexual activity and greater numbers of sexual partners than do youths in general. In 2011, among all races and ethnicities, AI/ANs had the second highest rates of chlamydia and gonorrhea and the third highest rates of primary and secondary syphilis. From 2011 through 2014, the US Department of Health and Human Services’ Family and Youth Services Bureau, through the Tribal Personal Responsibility Education Program (Tribal PREP), funded 14 tribes and tribal organizations to select, adapt, and implement culturally relevant, evidence-informed contraceptive and abstinence education curricula for their communities. Grantees also promoted successful transitions to adulthood by providing content on selected adulthood preparation subjects. Addressing these longstanding health inequities requires intervention and evaluation approaches that are culturally consonant with the tribal communities in which they will be used. An abundance of research emphasizes the importance of incorporating community-based participatory research approaches for culturally tailoring these interventions and evaluation methods. Drawing on this rich history, we extend the concept here by directly including the voices from front-line staff responsible for Tribal PREP program implementation as authors. Because there is little empirical research on evidence-based curricula and practices for AI/AN youths, the lessons learned by these program implementers offer firsthand experiences to further increase cultural awareness and improve future adolescent pregnancy prevention (APP) interventions for AI/AN adolescents, helping fill the gap in empirical research. (Author Introduction)

  • Individual Author: Bhatt, Chintan B. ; Beck-Sagué, Consuelo M.
    Reference Type: Journal Article
    Year: 2018

    Objectives. To explore the effect of Medicaid expansion on US infant mortality rate.

    Methods. We examined data from 2010 to 2016 and 2014 to 2016 to compare infant mortality rates in states and Washington, DC, that accepted the Affordable Care Act Medicaid expansion (Medicaid expansion states) and states that did not (non–Medicaid expansion states), stratifying data by race/ethnicity.

    Results. Mean infant mortality rate in non–Medicaid expansion states rose (6.4 to 6.5) from 2014 to 2016 but declined in Medicaid expansion states (5.9 to 5.6). Mean difference in infant mortality rate in Medicaid expansion versus non–Medicaid expansion states increased from 0.573 (P = .08) in 2014 to 0.838 in 2016 (P = .006) because of smaller declines in non–Medicaid expansion (11.0%) than in Medicaid expansion (15.2%) states. The 14.5% infant mortality rate decline from 11.7 to 10.0 in African American infants in Medicaid expansion states was more than twice that in non–Medicaid expansion states (6.6%: 12.2 to 11.4; P = .012).

    Conclusions....

    Objectives. To explore the effect of Medicaid expansion on US infant mortality rate.

    Methods. We examined data from 2010 to 2016 and 2014 to 2016 to compare infant mortality rates in states and Washington, DC, that accepted the Affordable Care Act Medicaid expansion (Medicaid expansion states) and states that did not (non–Medicaid expansion states), stratifying data by race/ethnicity.

    Results. Mean infant mortality rate in non–Medicaid expansion states rose (6.4 to 6.5) from 2014 to 2016 but declined in Medicaid expansion states (5.9 to 5.6). Mean difference in infant mortality rate in Medicaid expansion versus non–Medicaid expansion states increased from 0.573 (P = .08) in 2014 to 0.838 in 2016 (P = .006) because of smaller declines in non–Medicaid expansion (11.0%) than in Medicaid expansion (15.2%) states. The 14.5% infant mortality rate decline from 11.7 to 10.0 in African American infants in Medicaid expansion states was more than twice that in non–Medicaid expansion states (6.6%: 12.2 to 11.4; P = .012).

    Conclusions. Infant mortality rate decline was greater in Medicaid expansion states, with greater declines among African American infants. Future research should explore what aspects of Medicaid expansion may improve infant survival. (Author abstract)

     

  • Individual Author: Spillman, Brenda C.; Clemans-Cope, Lisa; Mallik-Kane, Kamala; Hayes, Emily
    Reference Type: Report
    Year: 2017

    Many states have expanded Medicaid eligibility to reach a wider array of vulnerable and historically uninsured populations. While Medicaid cannot pay for medical services provided in prisons or jails, people who are arrested and incarcerated can enroll in Medicaid and become eligible for benefits in the community. Given the high prevalence of mental health issues, substance abuse, and chronic health conditions among criminal justice populations, providing health care services to them could improve public health and public safety outcomes. This brief highlights initiatives in New York and Rhode Island that use the Medicaid health home model to improve continuity of care for justice-involved individuals. (Author abstract)

    Many states have expanded Medicaid eligibility to reach a wider array of vulnerable and historically uninsured populations. While Medicaid cannot pay for medical services provided in prisons or jails, people who are arrested and incarcerated can enroll in Medicaid and become eligible for benefits in the community. Given the high prevalence of mental health issues, substance abuse, and chronic health conditions among criminal justice populations, providing health care services to them could improve public health and public safety outcomes. This brief highlights initiatives in New York and Rhode Island that use the Medicaid health home model to improve continuity of care for justice-involved individuals. (Author abstract)

  • Individual Author: Hoffman, Denise; Hemmeter, Jeffrey; Bailey, Michelle S.
    Reference Type: Report
    Year: 2017

    Supplemental Security Income (SSI) recipients are presumed eligible for vocational rehabilitation services and youth who receive SSI may access those services as they prepare for the transition from school to work. Vocational rehabilitation (VR) is intended to help youth with disabilities become employed and maintain employment and thereby lessen their reliance on disability benefits in adulthood. In passing the Workforce Innovation and Opportunity Act in 2014, policymakers sought to expand VR and complementary services for transition-age youth with disabilities, in part to improve their employment outcomes in adulthood and decrease their reliance on benefits. In this brief, we document the rates of participation in VR by youth SSI recipients, describe the characteristics of youth who receive VR, and report on the association between youth’s VR participation and their employment and benefit outcomes in adulthood. Our findings indicate that, in 2001, 13 percent of youth SSI recipients ages 14 to 17 reported receiving VR services. Thirteen years later, when these individuals were...

    Supplemental Security Income (SSI) recipients are presumed eligible for vocational rehabilitation services and youth who receive SSI may access those services as they prepare for the transition from school to work. Vocational rehabilitation (VR) is intended to help youth with disabilities become employed and maintain employment and thereby lessen their reliance on disability benefits in adulthood. In passing the Workforce Innovation and Opportunity Act in 2014, policymakers sought to expand VR and complementary services for transition-age youth with disabilities, in part to improve their employment outcomes in adulthood and decrease their reliance on benefits. In this brief, we document the rates of participation in VR by youth SSI recipients, describe the characteristics of youth who receive VR, and report on the association between youth’s VR participation and their employment and benefit outcomes in adulthood. Our findings indicate that, in 2001, 13 percent of youth SSI recipients ages 14 to 17 reported receiving VR services. Thirteen years later, when these individuals were ages 27 to 30, a higher proportion had substantial earnings and a lower proportion received SSI compared with other SSI recipients who did not receive VR services, holding observable characteristics constant. We cannot determine the extent to which the associations between VR and these adult outcomes reflect unobserved differences between youth who participate in VR and those who do not versus the effect of VR services on outcomes. Nonetheless, the promising associations between VR and long-term adult outcomes highlight the potential benefits of providing early support to transition-age youth. (Author abstract)

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