Barriers to services for rural and urban survivors of rape

A significant proportion of survivors of rape do not utilize formal services to cope with the aftermath of rape. Understanding victimization experiences in environments that differ on resources, such as rural versus urban areas, may be an important dimension to consider in understanding barriers. Thirty women (18 rural and 12 urban) were recruited from rape crisis centers to participate in focus groups. Study results suggest that (a) survivors of rape experience many barriers to service utilization, (b) there were some differences in barriers to service utilization that were mentioned only in rural areas and some that were mentioned only in urban areas that may suggest that community context is important to consider in understanding barriers to service use, and (c) barriers to health and mental health services overlap with barriers to criminal justice system services.     

Making Choices: Adoption Seekers’ Preferences and Available Children with Special Needs

Most children available from public adoption agencies are children with special needs, such as disabilities. This pilot study on the child profile preferences of 5830 adults registered with province-wide adoption agency found that those who were most open to considering children with special needs had been formally seeking to adopt for some time and had completed government-required SAFE assessments and training. Most preferred younger children, and half would consider sibling groups. Between 43% to 60% indicated willingness to consider adopting children with degrees of learning disabilities, emotional behavioral disorders, and physical disabilities, although the willing proportion decreased as the level of each disability's specified impact progressed from “mild” to “moderate” to “severe.” Most preferred, among 20 categories of available children's possible exposures and health diagnoses, were past abuse exposures versus diagnosed disabilities or enduring conditions. Possible explanations for these findings and their implications are explored and ideas for further research proposed.     

Neighborhood Opportunity and Location Affordability for Low-Income Renter Families

Abstract

We use the Location Affordability Index (LAI) and the newly developed Child Opportunity Index (COI) to assess, for the first time, the tradeoff between neighborhood opportunity and housing/transportation affordability facing low-income renter families in the 100 largest metropolitan areas. In addition to describing the opportunity/affordability relationship, we explore the level of balance between neighborhoods’ relative cost burden and their corresponding opportunity levels to determine whether children of different racial/ethnic groups are more (or less) likely to experience cost-opportunity imbalance. Our multilevel analyses show that housing affordability is largely accounted for by the neighborhood opportunity structure within each metropolitan area. The metropolitan characteristics examined account for only a small proportion of the between-metro variance in the opportunity/affordability gradient for housing, presumably because the neighborhood opportunity structure already reflects metro area factors such as fragmentation and segregation. On the other hand, transportation affordability shows a weaker association with neighborhood opportunity. The COI/LAI association is much weaker for transportation than for housing, and a large part of the variation in the transportation gradient occurs at the metropolitan area level, not the neighborhood level. Sprawl is particularly associated with transportation affordability, with lower sprawl areas having lower transportation-cost burden. We discuss the implications of the empirical findings for defining affordability in housing assistance programs. We recommend that housing policy for low-income renter families adopt an expanded notion of affordability (housing, transportation, and opportunity) and explicitly consider equity (e.g. cost-opportunity imbalance) in the implementation of this expanded affordability definition.     

Patient-centered psychiatric care for youth in foster care: a systematic and critical review

Youth in the U.S. foster care system are prescribed risky psychotropic medications at high rates. In response, state child welfare agencies have developed policies, yet there is little research to inform patient-centered care (PCC) approaches. To fill this gap, we aimed to identify (1) the perspectives of youth in or formerly in foster care and their caregivers and providers regarding how psychiatric care aligns or does not align with PCC, and (2) effectiveness of interventions aiming to improve PCC within this context. We conducted a systematic review of the literature based on PRISMA-P guidelines, searching four databases and gray literature. Eleven studies met inclusion criteria and quality appraisal benchmarks, none of which were interventions. We applied narrative synthesis techniques to six studies that described youth/former youth perspectives. They described a pervasive lack of knowledge, perceived little voice in decision-making, and described imbalanced power between patients and providers and weak therapeutic relationships, whereas feeling understood by providers and being provided autonomy in decisions were helpful. Systemic barriers also contributed to many concerns. We make a limited number of recommendations to leaders and policy-makers based on our synthesis, however, many critical research steps are needed.     

Networking in the Shadow of the Law: Informal Access to Legal Expertise through Personal Network Ties

Civil legal problems are common in everyday life, but the costs of obtaining legal representation create barriers to legal action and contribute to disparities in access to justice. Some individuals, however, may have informal access to legal assistance through personal network ties with lawyers, enhancing their responses to justiciable problems. In this study, we draw from theories of social capital and network formation to examine the distribution and mobilization of network‐based legal expertise. Using nationally representative survey data, we find that network‐based access to lawyers is widespread, and most people who have ties to lawyers expect to informally mobilize legal assistance when facing a problem. But people who are most likely to afford formal legal representation are also most likely to have informal access to lawyers. Thus, while informal access to lawyers may shape responses to legal problems, it may also exacerbate inequalities in experiences with civil justice events.     

An Examination of the Influence of Veteran Status on Offense Type Among an Inmate Sample

The current study examines the relationship between military service and criminal behavior of veterans, both combat and non-combat, compared to non-veterans using a nationally representative sample of inmates. Specifically, this study examines the relationship between veteran status and crime type among inmates in state and federal institutions. While the relationship between military service and criminal behavior of veterans has received considerable attention, many have failed to differentiate between veterans who have seen combat versus those who have not. Therefore, a subsample of veterans who experienced combat during their military service is examined to better inform our understanding how combat experience might influence this relationship. Multiple counterfactual methods, including propensity score matching, were used on data from the Survey of Inmates in State and Federal Correctional Facilities, 2004. Some significant differences exist in the types of offenses committed based on veteran status and combat experience, but in some cases contrary to expectations. Veterans were more likely to have committed a violent offense, but less likely to have committed drug offenses; whereas, combat veterans were more likely to commit a drug offense and less likely to commit a violent offense than non-combat veterans. Policy implications and recommendations for future research are explored.     

Predictors of sexually coercive behavior in a nationally representative sample of adolescent males

Data from male participants in the National Longitudinal Study of Adolescent Health are used to examine childhood predictors of late adolescent and early adulthood sexually coercive behavior and adolescent mediators of these relationships. A path analysis shows that experiencing sexual abuse as a child has a direct effect on perpetrating subsequent coercion that is partially mediated by early sexual initiation. Involvement in delinquent activities in adolescence was the only additional significant predictor of sexually coercive behavior and completely mediated the relationship between physical abuse in childhood and later sexual coercion. Of note, more than half of men reporting sexually aggressive acts had no history of childhood victimization, so pathways to sexually coercive behavior for this group remain unidentified. In addition to the universal prevention approaches currently in use in the field, these findings suggest that targeted prevention programs need to be formulated for youth with histories of childhood sexual or physical abuse.     

Estimation and evidence in forensic anthropology: age-at-death

A great deal has previously been written about the use of skeletal morphological changes in estimating ages-at-death. This article looks in particular at the pubic symphysis, as it was historically one of the first regions to be described in the literature on age estimation. Despite the lengthy history, the value of the pubic symphysis in estimating ages and in providing evidence for putative identifications remains unclear. This lack of clarity primarily stems from the fact that rather ad hoc statistical methods have been applied in previous studies. This article presents a statistical analysis of a large data set (n = 1766) of pubic symphyseal scores from multiple contexts, including anatomical collections, war dead, and victims of genocide. The emphasis is in finding statistical methods that will have the correct "coverage."Coverage" means that if a method has a stated coverage of 50%, then approximately 50% of the individuals in a particular pubic symphyseal stage should have ages that are between the stated age limits, and that approximately 25% should be below the bottom age limit and 25% above the top age limit. In a number of applications it is shown that if an appropriate prior age-at-death distribution is used, then "transition analysis" will provide accurate "coverages," while percentile methods, range methods, and means (+/-standard deviations) will not. Even in cases where there are significant differences in the mean ages-to-transition between populations, the effects on the stated age limits for particular "coverages" are minimal. As a consequence, more emphasis needs to be placed on collecting data on age changes in large samples, rather than focusing on the possibility of inter-population variation in rates of aging.