Joining it up? Health and Wellbeing Boards in English Local Governance: Evidence from Clinical Commissioning Groups and Shadow Health and Wellbeing Boards

Statutory responsibility for health care and social care has long been separated between National Health Service (NHS) bodies and local government authorities. Repeated policy attempts to promote service integration through collaboration between such authorities have achieved little. The latest of such policy interventions are the Health and Wellbeing Boards (HWBs) established by the 2012 Health and Social Care Act (HSCA) alongside a range of other organisational innovations, including Clinical Commissioning Groups (CCGs). These organisations await full legal and operational status but have begun to develop structures and processes. HWBs are intended to lead the integrated assessment of local needs to inform both NHS health and local authority social care commissioners. We undertook detailed qualitative case studies in eight CCGs during 2011–2012 and here report observational and interview data related to CCGs’ perspectives and observations of early HWB developments. We found that developing HWBs vary greatly in their structure and approach, but we also identified a number of significant issues that are familiar from earlier research into health and social care integration. These include heavy dependence on voluntary agreements to align the strategic plans of the many different new statutory bodies; a significant role for mundane organisational processes in determining the extent of effective co-operation; and problems arising from factors such as size and the arrangements of local boundaries.     

Using Administrative Data to Monitor Racial/Ethnic Disparities and Disproportionality Within Child Welfare Agencies: Process and Preliminary Outcomes

Child welfare administrative data are increasingly used to identify racial/ethnic disproportionality and disparities at various levels of aggregation. However, child welfare agencies typically face challenges in harnessing administrative data to examine racial/ethnic disproportionality and disparities at meaningful levels of analysis due to limited resources and/or tools for reporting. This article describes the process through which a multi-state workgroup designed and developed management reports to monitor racial/ethnic disparities and disproportionality using a web-based child welfare administrative data reporting system. The article provides an overview of the process, outcome, and challenges of the group’s work with the goal of offering a starting point for discussion to others who may be seeking to monitor racial/ethnic disparities and disproportionality, regardless of their reporting system.     

Economic Burden of Child Exposure to Intimate Partner Violence in the United States

Because the effects of children’s exposure to intimate partner violence (IPV) carry long lasting consequences for the affected children, IPV exposure may impose a significant economic burden to localities, states, and society at large, made explicit over the victim’s lifetime and over a wide range of behaviors and outcomes, including use of social services, health and healthcare utilization, educational outcomes, workforce productivity, and criminal behavior. While much research has been conducted on the effect of IPV exposure on multiple short- and long-term outcomes, no research to date has examined the economic burden associated with IPV exposure. Using an incidence-based approach, we estimated the aggregate discounted costs associated with healthcare spending, criminal behavior, and labor market productivity accrued by a 20-year-old victim in 2016 projected to the age of 65, applying a 3% discount rate. The average lifetime costs derived from childhood IPV exposure are estimated to be over $50,000 per victim (2016 U.S. dollars) due to increased healthcare costs ($11,000), increased crime costs ($14,000), and productivity losses ($26,000). Over an annual birth cohort of young adults, these costs amount to over $55 billion nationwide. IPV exposure imposes a substantial economic burden to society at large in the form of increased healthcare costs, increased crime costs, and reduced productivity. This study offers an explicit quantification of substantial lifetime costs, which should encourage policy makers to redouble efforts to reduce the incidence of IPV and successfully ameliorate its effects on IPV-exposed children.     

A Perspective on Errors,Bias, and Interpretation in the Forensic Sciences and Direction for Continuing Advancement*

Abstract: The forensic sciences are under review more so than ever before. Such review is necessary and healthy and should be a continuous process. It identifies areas for improvement in quality practices and services. The issues surrounding error, i.e., measurement error, human error, contextual bias, and confirmatory bias, and interpretation are discussed. Infrastructure is already in place to support reliability. However, more definition and clarity of terms and interpretation would facilitate communication and understanding. Material improvement across the disciplines should be sought through national programs in education and training, focused on science, the scientific method, statistics, and ethics. To provide direction for advancing the forensic sciences a list of recommendations ranging from further documentation to new research and validation to education and to accreditation is provided for consideration. The list is a starting point for discussion that could foster further thought and input in developing an overarching strategic plan for enhancing the forensic sciences.     

Development and Initial Validation of the Miranda Vocabulary Scale

Miranda vocabulary forms the essential foundation for Miranda comprehension and subsequent decisions to exercise or waive Miranda rights. The purpose of the current study is the development of the Miranda Vocabulary Scale (MVS), designed to evaluate key vocabulary words found in Miranda warnings and waivers across American jurisdictions. A preliminary list of MVS words was refined by expert ratings and by each word’s discriminability between failed and good Miranda comprehension. Miranda and other measures were collected at multiple sites on 376 pretrial defendants. With further refinements, the MVS is composed of 36 words with excellent scale homogeneity and interrater reliability (r = .99). It also demonstrated good convergent and discriminant validity for cognitive abilities and psychological impairment.     

Social analytic investigation of hostile work environments

This paper presents a brief psycholegal analysis of hostile work environment sexual harassment law especially as it distinguishes between the reasonable person and reasonable woman tests of severity and pervasiveness. We tested two hypotheses: (1) women (but not men) would show stronger judgments of harassment when using the reasonable woman standard, and (2) this relationship would be strongest for women who identified with harassed victims and men who did not. We presented to a sample of undergraduates an in-group identification measurement task followed by the fact patterns in two cases and asked them to make legally relevant decisions under either the reasonable woman or person standard. Although we found gender and in-group identification effects, we found no legal standard effects. The results are discussed from the perspectives of law and psychology.