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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: Mueller, Keith J. ; Alfero, Charlie ; Coburn, Andrew F. ; Lundblad, Jennifer P. ; MacKinney, A. Clinton ; McBride, Timothy D. ; Barker, Abigail
    Reference Type: Report
    Year: 2018

    This paper discusses the realities and challenges of designing a market structure that will result in affordable health insurance being offered in rural markets, and reviews the rural implications of policies affecting rural health insurance markets and health systems. (Edited author introduction)

     

    This paper discusses the realities and challenges of designing a market structure that will result in affordable health insurance being offered in rural markets, and reviews the rural implications of policies affecting rural health insurance markets and health systems. (Edited author introduction)

     

  • Individual Author: Green, Michael J.; Stritzel, Haley; Smith, Chelsea; Popham, Frank; Crosnoe, Robert
    Reference Type: Journal Article
    Year: 2018

    Childhood poverty is associated with poorer adolescent health and health behaviours, but the importance of the timing of poverty remains unclear. There may be critical or sensitive periods in early life or early adolescence, or poverty may have cumulative effects throughout childhood. Understanding when poverty is most important can support efficient timing of interventions to raise family income or buffer against the effects of low income, but answers may vary across social contexts. The US and the UK are a useful comparison with similar liberal approaches to cash transfers, but very different approaches to healthcare provision. Utilising data from large population studies in the US (n = 9408; born 1979–1996) and UK (n = 1204; born 1991–1997), this study employs a structured life course approach to compare competing hypotheses about the importance of the timing or pattern of childhood exposure to poverty in predicting adolescent health limitations, symptoms of psychiatric distress, and smoking at age 16 (age 15/16 in US). Household income histories identified experience of...

    Childhood poverty is associated with poorer adolescent health and health behaviours, but the importance of the timing of poverty remains unclear. There may be critical or sensitive periods in early life or early adolescence, or poverty may have cumulative effects throughout childhood. Understanding when poverty is most important can support efficient timing of interventions to raise family income or buffer against the effects of low income, but answers may vary across social contexts. The US and the UK are a useful comparison with similar liberal approaches to cash transfers, but very different approaches to healthcare provision. Utilising data from large population studies in the US (n = 9408; born 1979–1996) and UK (n = 1204; born 1991–1997), this study employs a structured life course approach to compare competing hypotheses about the importance of the timing or pattern of childhood exposure to poverty in predicting adolescent health limitations, symptoms of psychiatric distress, and smoking at age 16 (age 15/16 in US). Household income histories identified experience of poverty (measured as <60% of the national median equivalised income for a given year) in early life (ages 0–5), mid-childhood (ages 6–10) and early adolescence (ages 11–15). The Bayesian Information Criterion (BIC) compared fit across models with variables representing different life course patterns of exposure to poverty. Adolescent distress was not associated with poverty in either country. In both countries, however, variables representing cumulative or persistent experiences of poverty exhibited optimal fit of all poverty exposure variables in predicting adolescent smoking and health limitations. There was also evidence of an early life sensitive period for smoking in the US. Poverty was more persistent in the US, but associations between poverty and outcomes were consistent across countries. Although poverty can have cumulative effects on health and behaviour, early interventions may offer the best long-term protection. (Author abstract)

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