Daniel R. Meyer

Common-Sense Models of Illness: The Example of Hypertension

Our premise was that actions taken to reduce health risks are guided by the actors subjective or common-sense constructions of the health threat. We hypothesized that illness threats are represented by their labels and symptoms (their identity), their causes, consequences, and duration. These attributes are represented at two levels: as concrete, immediately perceptible events and as abstract ideas. Both levels guide coping behavior. We interviewed 230 patients about hypertension, presumably an asymptomatic condition. When asked if they could monitor blood pressure changes, 46% of 50 nonhypertensive, clinic control cases said yes, as did 71% of 65 patients new to treatment, 92% of 50 patients in continuing treatment, and 94% of 65 re-entry patients, who had previously quit and returned to treatment. Patients in the continuing treatment group, who believed the treatment had beneficial effects upon their symptoms, reported complying with medication and were more likely to have their blood pressure controlled. Patients new to treatment were likely to drop out of treatment if: they had reported symptoms to the practitioner at the first treatment session, or they construed the disease and treatment to be acute. The data suggest that patients develop implicit models or beliefs about disease threats, which guide their treatment behavior, and that the initially most common model of high blood pressure is based on prior acute, symptomatic conditions.

Before and After TANF: The Economic Well‐Being of Women Leaving Welfare

We use administrative data from Wisconsin to compare employment, earnings, and income outcomes for welfare leavers under early reforms and under the later, more stringent Temporary Assistance for Needy Families program. We find substantially higher rates of exit in the later period. Later leavers are somewhat more likely to work, but their earnings are lower. We also make a pre‐post comparison of individual employment and income experiences, examining a leaver’s outcomes during a calendar quarter of welfare receipt with these outcomes a year after leaving welfare. On average, substantial earnings growth is outweighed by declines in benefits, resulting in reduced total measured net income.

Custodial Fathers: Myths, Realities, and Child Support Policy

Men are increasingly receiving custody of their children, and single-father families with children are increasing at a faster rate than even single-mother families. Howewer, many observers still believe that there are few custodial fathers. Indeed, there are number of myths concerning custodial fathers. We examine three data sets and determine that many of these assumptions about custodial fathers are simply not true. We argue that current child support policies should be re-examined to ensure that they follow the same principles when the custodial parent is the father as when the custodial parent is the mother.

Who gets custody

Changes in the living arrangements of children have implications for social policy and children’s well-being. Understanding who gets custody on divorce—mother, father, or both sharing custody—can also inform our understanding of family organization and the merits of alternative theories of marriage and divorce. We examine physical-custody outcomes among recent Wisconsin divorces in an effort to understand the factors associated with shared custody as well as mother-sole custody and father-sole custody. Although mother-sole custody remains the dominant arrangement, shared custody has increased over a nine-year period. We find that the probability of shared custody increases with parent’s income. Prior marital history. parents’ ages, the age and gender of children, and the legal process also have an impact on the probability of shared custody. In contrast to shared custody, the probability of father-sole custody decreases with parent’s income, while the relationship with other significant factors is generally similar. The notable exception is that, unlike shared custody, we find no evidence for an increase over time in the probability of father-sole custody. We also find that when the father has a higher proportion of the Couple’s total income, both shared custody and father-sole custody are more likely.

Multiple‐Partner Fertility: Incidence and Implications for Child Support Policy

Family complexity that results when adults have children with multiple partners (multiple‐partner fertility) is quite common. It also has important implications for understanding child support outcomes and for designing and evaluating welfare and family policy. Using a unique set of merged administrative data, this article provides the first comprehensive documentation of levels of family complexity among a broad sample of welfare recipients. The analyses suggest that family complexity is very common and also that complexity is associated with systematically different child support outcomes.

Economic Well-Being Following an Exit from Aid to Families with Dependent Children.

Much previous research has focused on how long families receive Aid to Families with Dependent Children (AFDC) before leaving the program and whether and when they return to the program following an exit. Few quantitative studies have looked at broader indicators of the economic well-being of those who have exited AFDC. We use data from the National Longitudinal Survey of Youth to trace poverty status and welfare use in the 5 years following an exit from AFDC. We find substantial diversity in economic well-being. Women who were working when they exited from AFDC do better, and, to a lesser extent, so do those who were married or had a partner when they exited. Higher levels of success are achieved by women with higher earning potential, including those with higher education and those with fewer children or older children. Although some women achieve modest levels of economic success, 41% remain poor even 5 years after an exit from AFDC. Our results highlight the distinction between leaving welfare and leaving poverty and suggest that welfare reforms targeted at reducing caseloads may do relatively little to enhance broader measures of economic success. Key Words: AFDC, poverty, self-sufficiency, welfare. The goal of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 and, to a lesser extent, of previous welfare reforms has been to move women and children off the welfare rolls. Yet we know little about the lives of women and children who have left welfare. Recent research shows that many women who exit from Aid to Families with Dependent Children return-some of them quite quickly, suggesting that life after welfare is a time of economic insecurity for many women and their children (Blank & Ruggles, 1994; Brandon, 1995; Cao, 1996; Gritz & MaCurdy, 1991; Harris, 1996; Meyer, 1993; Pavetti, 1993). But the degree of economic insecurity of those who have left welfare is not yet fully understood because the focus of research generally has been limited to examining returns to welfare. Broader measures of economic well-being are critical; leaving welfare is not synonymous with leaving poverty. As we show in our analysis, the assessment of womens economic success after leaving welfare varies substantially with the measure used. There is little analysis of the extent to which families are able to move out of poverty and into a life of self-sufficiency once they leave AFDC. This article begins to fill this gap. We analyze poverty, welfare use, and alternative sources of income for young women who left AFDC in the 1980s. After reviewing related literature and discussing our data and approach, we analyze the factors associated with womens economic success following an exit from AFDC. Understanding the level of economic wellbeing after AFDC and factors associated with well-being is particularly important in the context of current policy. The Personal Responsibility and Work Opportunity Reconciliation Act eliminates the entitlement to cash assistance and replaces AFDC with a block grant, titled Temporary Assistance for Needy Families (TANF), to the states. Given the block-grant structure, there likely will be substantial variation in the programs that replace AFDC. Nonetheless, the legislation requires that all programs have time limits on the receipt of cash assistance and that all programs lead to substantial increases in employment. Analysis of the levels of well-being and self-sufficiency attained by women who have left AFDC in the past can provide a reference point for the design and evaluation of welfare reforms. Economic theory (as well as anecdotal evidence) suggests that women who have left AFDC in the past are likely to have better prospects of employment and marriage than many who may lose cash assistance under TANF because those with the most attractive alternatives had the greatest incentive to leave. Nonetheless, the experiences of women who have left AFDC provide some of the best information currently available on the conditions of life after welfare. …

Child Support Compliance among Discretionary and Nondiscretionary Obligors

This article documents patterns and correlates of child support compliance among fathers of welfare recipients in Wisconsin. We introduce the concept of discretionary obligors (because payment results in part from voluntary cooperation) and nondiscretionary obligors (because payment results from routine enforcement mechanisms) to differentiate between fathers with weak versus strong connections to formal employment, and we demonstrate that different factors underlie the compliance patterns of these groups.

Reconsidering the increase in father-only families

Previously reported estimates of rapid growth rates among father-only families did not account for cohabitation. An explicit treatment of cohabitation removes about half of the presumed growth. Nevertheless, we find that the number of father-only families grew at more than double the rate of mother-only families during the 1980s. Decomposition analyses show that the largest factor associated with the increase is that fathers now head a greater proportion of all formerly married single-parent families with children. Although the share of single-parent families headed by fathers is larger in 1990 than in 1980 even after controlling for cohabitation, it is smaller than in 1970.

A Note on the Antipoverty Effectiveness of Child Support among Mother-Only Families

The Current Population Survey is used to examine the antipoverty effectiveness of child support, social insurance, and welfare among mother-only families in 1995. Child support brought about 6-7 percent of pretransfer poor mother-only families over the poverty line, an effect similar to that of social insurance and welfare. A brief trend analysis shows that child supports antipoverty effectiveness has been growing. Some potential reasons why child supports effect is still so small in the face of substantial changes in child support policy are hypothesized.

Child Support and Welfare Dynamics: Evidence from Wisconsin*

This paper provides estimates of the effect of child support on exiting and reentering welfare for a sample of divorced women in Wisconsin. Modest amounts of child support do not have large effects on exiting welfare in this sample. The percentage of women who return to welfare is higher than has been reported previously. Receiving child support significantly decreases the likelihood of returning to welfare.