Health insurance for Americans approaching age sixty-five: an analysis of options for incremental reform

This article provides a systematic evaluation of the options for incremental health insurance reforms aimed at older Americans nearing age sixty-five. It presents three basic arguments for giving special consideration to this age group: (1) early retirement and its effect on access to employer insurance; (2) changes in health and health care expenses associated with increasing age; (3) the vulnerability to unexpected economic or health "shocks" that will affect people throughout their retirement. The analysis of policy options begins by specifying criteria for evaluating alternative approaches to reform. The proposed criteria emphasize that reforms for this age group should be designed to fit with other financial plans and decisions made during such a transitional stage of life. Policy options should be judged according to fundamental goals such as equity and efficiency, not simply ranked according to the number of uninsured who will gain coverage. After offering a comprehensive catalog and evaluation of available options, the analysis identifies and discusses a preferred approach-which preserves choices while offering universal and subsidized access to Medicare before age sixty-five.     

Patterns of Practice in Mental Health Courts: A National Survey

Mental health courts (MHCs) represent an important new development at the interface of the criminal justice and mental health systems. MHCs are criminal courts for persons with mental illness that were in part created to divert this population from jail/prison into community treatment. MHCs are proliferating rapidly despite limited knowledge regarding their characteristics or their efficacy. We surveyed the entire population of adult MHCs in the United States, n = 90. In the past 8 years, MHCs have been created in 34 states, with an aggregate current caseload of 7,560 clients in MHCs nationally. Most courts (92%) reported using jail as a sanction for noncompliance, if only rarely. Further, jail sanction use was significantly predicted by increased judicial supervision and number of felons in the court. Implications for MHCs and social monitoring are discussed.     

Adolescent sexual activity and pregnancy: Socioenvironmental problems,physical health,and mental health

This paper examines the association between adolescent pregnancy and socioenvironmental, physical, and mental health problems in 1590 inner-city females aged 13–18 who use health clinics. Adolescents who have become pregnant, those who are sexually active but never have been pregnant, and those who are sexually inactive are compared. The sexually active youngsters come from more psychosocially disadvantaged backgrounds than their sexually inactive peers; the sexually active girls who become pregnant come from more psychosocially disadvantaged backgrounds than those who have never been pregnant. Despite this, the youths who have become pregnant do not have more current relationship problems, more stressful life events, or worse physical health than the never-pregnant sexually active youths. Although sexually inactive youths have the lowest rates of mental health problems, adolescents who have been pregnant have lower rates of anxiety and conduct disorder symptoms than those who are sexually active but never pregnant.Supported by the Robert Wood Johnson Foundation. Fieldwork conducted by Survey Research Associates.Research interests include adolescents and children, parenting, and families.Research interests include epidemiology of child and adolescent psychiatric disorder.Research interests include psychiatric epidemiology/deviant behavior.Research interests include mental health and statistical issues.Research interests include health behavior and mental health issues.     

The utility of the State-Trait Anger Expression Inventory with offenders

Self-report instruments can provide useful information as part of a thorough clinical assessment. However, their use in forensic settings can be problematic. The State-Trait Anger Expression Inventory (STAXI) has recently been proposed as an effective instrument for screening and outcome measurement in anger management programs. This study evaluated the effectiveness of this instrument in a sample of both voluntary and court-ordered anger-management clients, all of whom were determined through diagnostic interviews to have significant anger problems. Contrary to findings in nonforensic samples, the STAXI Trait Anger scale identified only about half of the participants as having anger-management problems severe enough to require intervention. Supplemental analysis with two additional scales did not significantly improve sensitivity. In addition to thorough diagnostic interviewing, forensic use of the STAXI (like similar assessment methods) may require additional validity scales to detect denial or socially desirable response patterns.     

Girl Farm Labour and Double-shift Schooling in The Gambia: The Paradox of Development Intervention

This article examines the intensification of Gambian girls’ domestic and farm labour contributions as a result of the introduction of double-shift schooling. Drawing on fieldwork among female farmers and their daughters in Brikama the article puts forth the following arguments: doubleshift schooling facilitates the intensification and increased appropriation of surplus value from girls’ household and farm labour because girls are more readily able to meet gendered labour obligations that are central to the moral economy of the household and to the demands of agrarian production; secondly, double-shift schooling highlights the paradoxical nature of development intervention where, on the one hand, legislation and policy call for a reduction in child labour by increasing access to school and, on the other, neo-liberal educational policy serves to facilitate the intensification of girls’ domestic and farm labour. This paper maintains that the intensification of girls’ workmust be placed within a wider context where children’s — particularly girls — cheap, flexible and/or unremunerated labour is central to the functioning of local and global processes of accumulation.     

Adoption and Victorian culture

In 1888, evangelical, educator and feminist Constance Maynard adopted Effie Anthon, a six year old girl from a Salvation Army orphanage. Her mother, Rosabianca Fasulo was an unmarried, Italian woman recently “rescued” by the Salvation Army. Maynard anticipated that Effie would one day join her at her college but she met none of the expectations for her. She entered domestic service but fell ill with tuberculosis and died in a workhouse in 1915. This is one particular case history of an adoption when the practice was not yet formalized but small numbers began to adopt children unknown to them. It tentatively opens up the history of adoption in Victorian Britain. It also illuminates some broader questions about family ties, the meanings associated with motherhood, and how the body and character formation were understood.     

The limits of policy

This article uses public documents and first-hand accounts of late 19th and early 20th centuries child life to examine attempts by public policymakers in the United States and New Zealand to change the quality of rural child life in those countries through compulsory schooling and other related measures. These attempts, however, largely failed due to the demands of the farming economy and the unwillingness of public officials to go to extraordinary lengths on behalf of farm children, as opposed to urban children. Rural children's lives would be changed, not by policy, but by technological developments and the vagaries of the farm economy.