Administrative burden is an individual's experience of policy implementation as onerous. Such burdens may be created because of a desire to limit payments to ineligible claimants, but they also serve to limit take-up of benefits by eligible claimants. For citizens, this burden may occur through learning about a program; complying with rules and discretionary bureaucratic behavior to participate; and the psychological costs of participating in an unpopular program. Using a mixed-method approach, the authors explain process changes that reduced individual burden and demonstrate how this resulted in increased take-up in Medicaid in the state of Wisconsin. The findings inform the planned expansion of Medicaid under the Patient Protection and Affordable Care Act. A key design principle for Medicaid and other means-tested programs is that it is possible to increase program take-up while maintaining program integrity by shifting administrative burdens from the citizen to the state.
Partly because of the widespread tendency for Americans to think of themselves as “middle class,” subjective class identity often does not correspond to objective class position. This study evaluates the extent to which American voters' subjective class identities differ from their objective class positions. We then evaluate the implications of such differences for voting behavior using American National Election Studies data from eight recent presidential elections. Coding respondents according to whether subjective class identity is higher or lower than objective class position, we construct a novel schema of inflated, deflated, and concordant class perceptions. We find that there are substantial differences between Americans' subjective and objective social class: over two-thirds of the upper-middle class have a deflated perception of their class position, only half of the middle class have concordant perceptions, and more than a third of the working class have inflated perceptions. We also find that this divergence varies depending on sociodemographic factors, and especially race and education. The analyses initially show a pattern that those with inflated class perceptions are more likely to vote Republican. However, this relationship is not significant once we control for race and income.
This article reviews and evaluates recent comparative social science scholarship on healthcare systems. We focus on four of the strongest themes in current research: (a) the development of typologies of healthcare systems, (b) assessment of convergence among healthcare systems, (c) problematization of the shifting boundaries of healthcare systems, and (d) the relationship between healthcare systems and social inequalities. Our discussion seeks to highlight the central debates that animate current scholarship and identify unresolved questions and new opportunities for research. We also identify five currents in contemporary sociology that have not been incorporated as deeply as they might into research on healthcare systems. These five missed turns include emphases on social relations, culture, postnational theory, institutions, and causal mechanisms. We conclude by highlighting some key challenges for comparative research on healthcare systems.
Scholars have long noted how migration streams, once initiated, obtain a self-feeding character. Studies have attributed this phenomenon – the cumulative causation of migration – to expanding social networks that connect migrants in destination to individuals in origin. Studies however, often disagree on how social networks influence migration decisions. While many establish a positive association between individuals’ ties to prior migrants and their migration propensities, only few acknowledge that multiple social mechanisms might account for these interdependencies. To address this issue, we adopt a typology developed by DiMaggio and Garip (2012) and consider three mechanisms by which social ties may influence individuals’ migration choices. We study the prevalence of these mechanisms in the Mexico-US migration context using a mixed methods approach. First, analyzing data from more than 90,000 individuals surveyed by the Mexican Migration Project (MMP) we establish the presence of network effects in migration and test how prior migrants in the family or community increase individuals’ migration propensities, and whether prior migrants reduce the effect of economic or political indicators on migration propensities. Second, we analyze qualitative data from 120 in-depth interviews to determine the different mechanisms that lead to interdependencies in individuals’ migration choices. We thus provide a deeper understanding of migration as a social process, which we contend is crucial for anticipating future flows and policy responses.
How do national social programs influence local voting? This study utilizes the experimental set up of a conditional cash transfer program to show that small, targeted cash transfers can have large electoral effects. The Honduran PRAF program allocated an average of $18 per capita per year to poor households within municipalities that were randomly assigned to receive the program. Although the program was administered at the national level, the program increased an incumbent mayor’s re-election probabilities by 39%, without significantly influencing voting behavior in presidential elections. Moreover, the evidence suggests that transferring cash to poor households were more effective at increasing political support than interventions providing public goods for poor villages.
Abstract A common proposition in welfare state research is that programs financed through dedicated payroll taxes tend to be more durable. This article examines American unemployment insurance (UI) as an exception to this proposition. UI is a self-financed social insurance program whose benefits have been dismantled over time because of an inability to maintain a constant revenue base. The study first examines the long-run decline in UI finances and concludes that changes in UI taxes are associated with the largest declines in state finances. It then examines why more states have not pursued reforms to strengthen UI finances and finds that opponents of more generous UI benefits have generally succeeded in preventing such measures, thus constricting UI finances and gradually retrenching benefits. These findings have implications for those seeking to improve UI solvency, as well as for the study of welfare state retrenchment more generally.
This paper explores whether educational attainment has a cognitive reserve capacity in elder life. Using pilot data from the China Health and Retirement Longitudinal Study (CHARLS), we examined the impact of education on cognitive abilities at old ages. OLS results showed that respondents who completed primary school obtained 18.2 percent higher scores on cognitive tests than those who did not. We then constructed an instrumental variable (IV) by leveraging China’s Great Famine of 1959e1961 as a natural experiment to estimate the causal effect of education on cognition. Two-stage least squares (2SLS) results provided sound evidence that completing primary school significantly increases cognition scores, especially in episode memory, by almost 20 percent on average. Moreover, Regression Discontinuity (RD) analysis provides further evidence for the causal interpretation, and shows that the effects are different for the different measures of cognition we explored. Our results also show that the Great Famine can result in long-term health consequences through the pathway of losing educational opportunities other than through the pathway of nutrition deprivation.
In this paper, we build on the literature that examines associations between height and health outcomes of the elderly. We investigate the associations of height shrinkage at older ages with socioeconomic status, finding that height shrinkage for both men and women is negatively associated with better schooling, current urban residence, and household per capita expenditures. We then investigate the relationships between pre-shrinkage height, height shrinkage, and a rich set of health outcomes of older respondents, finding that height shrinkage is positively associated with poor health outcomes across a variety of outcomes, being especially strong for cognition outcomes.
Scholars of presidential primaries have long posited a dynamic positive feedback loop between fundraising and electoral success. Yet existing work on both directions of this feedback remains inconclusive and is often explicitly cross-sectional, ignoring the dynamic aspect of the hypothesis. Pairing high-frequency FEC data on contributions and expenditures with Iowa Electronic Markets data on perceived probability of victory, we examine the bidirectional feedback between contributions and viability. We find robust, significant positive feedback in both directions. This might suggest multiple equilibria: a candidate initially anointed as the front-runner able to sustain such status solely by the fundraising advantage conferred despite possessing no advantage in quality. However, simulations suggest the feedback loop cannot, by itself, sustain advantage. Given the observed durability of front-runners, it would thus seem there is either some other feedback at work and/or the process by which the initial front-runner is identified is informative of candidate quality.
Nearly a century of empirical research examines how neighborhood properties influence a host of phenomena such as crime, poverty, health, civic engagement, immigration, and economic inequality. Theoretically bundled within these neighborhood effects are institutions’ and actors’ social networks that are the foundation of other neighborhood-level processes such as social control, mobilization, and cultural assimilation. Yet, despite such long-standing theoretical links between neighborhoods and social networks, empirical research rarely considers or measures dimensions of geography and social network mechanisms simultaneously. The present study seeks to fill this gap by analyzing how both geography and social networks influence an important social problem in urban America: gang violence. Using detailed data on fatal and non-fatal shootings, we examine effects of geographic proximity, organizational memory, and additional group processes (e.g., reciprocity, transitivity, and status seeking) on gang violence in Chicago and Boston. Results show adjacency of gang turf and prior conflict between gangs are strong predictors of subsequent gang violence. Furthermore, important network processes, including reciprocity and status seeking, also contribute to observed patterns of gang violence. In fact, we find that these spatial and network processes mediate racial effects, suggesting the primacy of place and the group in generating gang violence.