Elizabeth E. Davis

Accounting for the Decline in AFDC Caseloads: Welfare Reform or the Economy?

We use state-level monthly panel data to assess the relative contributions of the macroeconomy and welfare reform in accounting for the 1993-96 decline in Aid to Families with Dependent Children (AFDC) caseloads. Our results suggest that the decline in per capita AFDC caseloads is attributable largely to the economic conditions in states and not to waivers from federal welfare policies. Nationwide, we attribute 66 percent of the decline to the macroeconomy. However, we do find substantial heterogeneity in the impact and timing of alternative waivers on AFDC caseloads. States with waivers impacting parental responsibilities experienced greater caseload declines than states with waivers that made work more attractive. Overall, our model predicts that had it not been for the influence of economic factors, welfare reform would not have led to any decrease in aggregate caseloads.

Doctor, my tooth hurts: the costs of incomplete dental care in the emergency room

OBJECTIVES This study aims to examine the charges and frequency of return visits for treating dental health problems in hospital emergency rooms (ERs) in order to provide a basis for policy discussion concerning cost-effective and appropriate treatment for those without access to private dental services. METHODS Records were abstracted from hospital administrative data systems for dental-related ER visits from five major hospital systems in the Minneapolis-St. Paul metropolitan area during a 1-year period. Data on the number of visits and charges were analyzed by age and type of payor (public or private). Similar data were obtained from records for a commercially insured population from a single large employer. RESULTS There were over 10,000 visits to ERs for dental-related problems with total charges reaching nearly

Doctor, my tooth hurts

5 million in 1 year, mainly charged to public programs and reimbursed at about 50 percent. The frequency of repeat visits suggests that while acute pain and infection were treated by the ER physicians, the underlying dental problem often was not resolved. In contrast, a population with commercial dental insurance rarely used hospital ERs for dental problems. CONCLUSIONS Access to preventive and restorative dental care is a critical public health problem in the United States, particularly for those without insurance and those covered by public programs. Public health policy initiatives such as the use of dental therapists should be expanded to improve access and to provide alternatives that offer more complete and less costly care for oral health problems than do hospital ERs.

Product Market Competition and Human Resource Practices: An Analysis of the Retail Food Sector

OBJECTIVES This study aims to examine the charges and frequency of return visits for treating dental health problems in hospital emergency rooms (ERs) in order to provide a basis for policy discussion concerning cost-effective and appropriate treatment for those without access to private dental services. METHODS Records were abstracted from hospital administrative data systems for dental-related ER visits from five major hospital systems in the Minneapolis-St. Paul metropolitan area during a 1-year period. Data on the number of visits and charges were analyzed by age and type of payor (public or private). Similar data were obtained from records for a commercially insured population from a single large employer. RESULTS There were over 10,000 visits to ERs for dental-related problems with total charges reaching nearly

Decomposing the Sources of Earnings Inequality: Assessing the Role of Reallocation

5 million in 1 year, mainly charged to public programs and reimbursed at about 50 percent. The frequency of repeat visits suggests that while acute pain and infection were treated by the ER physicians, the underlying dental problem often was not resolved. In contrast, a population with commercial dental insurance rarely used hospital ERs for dental problems. CONCLUSIONS Access to preventive and restorative dental care is a critical public health problem in the United States, particularly for those without insurance and those covered by public programs. Public health policy initiatives such as the use of dental therapists should be expanded to improve access and to provide alternatives that offer more complete and less costly care for oral health problems than do hospital ERs.

THE IMPACT OF THE 1990s ECONOMIC BOOM ON LESS-EDUCATED WORKERS IN RURAL AMERICA

The rise of super-centers and the entry of Wal-Mart into food retailing have dramatically altered the competitive environment in the industry. This paper explores the impact of such changes on the labor market practices of traditional food retailers. We use longitudinal data on workers and firms to construct new measures of compensation and employment, and examine how these measures evolve within and across firms in response to changes in product market structure. An additional feature of the analysis is to combine rich case study knowledge about the retail food industry with the new matched employer-employee data from the Census Bureau.

Time for a change? Predictors of child care changes by low-income families

This paper exploits longitudinal employer-employee matched data from the U.S. Census Bureau to investigate the contribution of worker and firm reallocation to changes in earnings inequality within and across industries between 1992 and 2003. We find that factors that cannot be measured using standard cross-sectional data, including the entry and exit of firms and the sorting of workers across firms, are important sources of changes in earnings distributions over time. Our results also suggest that the dynamics driving changes in earnings inequality are heterogeneous across industries.

The Problem of Measurement Error in Self-Reported Receipt of Child-Care Subsidies: Evidence from Two States

We use national longitudinal survey data (NLSY79) to investigate the impact of local labor market conditions on the employment and earnings of rural non-college-educated workers. Results suggest that local economic conditions in the late 1990s did have a positive impact on wages, and the effect is larger for workers with no more than a high school degree compared to their college-educated counterparts. We find little evidence of a difference between rural and urban impacts, suggesting that the 1990s boom helped both rural and urban less-educated workers. These results suggest that an expanding economy continues to be a powerful anti-poverty force.This study uses National Longitudinal Survey of Youth (NLSY79) data to investigate whether the effect of local labor market conditions on the earnings of workers differs by gender, education level, or metropolitan/nonmetropolitan location. The results suggest that local economic conditions in the late 1990s did have a positive effect overall on wages for men with no more than a high school degree and for women regardless of education. Further, there is evidence of a difference between metro and nonmetro labor markets, suggesting that the 1990s boom helped urban less-educated workers but not those in rural areas. The metro-nonmetro difference is most apparent for male workers.

Productivity and efficiency impacts of human resources practices in food retailing

Instability in child care arrangements can negatively affect childrens development, especially in low-income families. However, few studies have examined what predicts changes over time in child care arrangements. This paper presents findings from a unique multiyear study tracking child care use in low-income families. We estimate rich quantitative models to analyze the relationships among child, household, and care provider characteristics and four different types of changes. We find turnover in child care arrangements to be common in this low-income population. Over a period of six months, half of the children changed primary provider. Child care changes were frequently related to job loss, changes in family composition, or the changing availability of caregivers. While concerns have been raised that short spells of child care subsidy receipt cause child care instability, we found that subsidy use was not associated with higher rates of change. In addition, we found that the lower a parents assessment of the childs experience in a particular arrangement in the prior time period, the higher the likelihood of changing providers by the next survey wave. These results indicate that low-income parents recognize quality factors and change arrangements to improve the quality of care.

Product Market Competition and Human Resource Practices in the Retail Food Sector

Researchers frequently rely on survey responses to determine whether families receive government assistance and to study the effects of government programs, but these responses are often inaccurate. This study investigates misreporting in the child-care subsidy program by comparing survey responses on child-care subsidy receipt with program administrative data in two states. While we find a lower rate of misreporting than is typical for other government assistance programs, overreporting of benefit receipt is surprisingly common and generates overestimates of program participation. Analyses further suggest that the frequency and systematic nature of misreporting bias estimates of the predictors of program receipt and the effects of the program. These findings illustrate the necessity of assessing the frequency of response errors and understanding their implications in generating valid research results on the effects of government programs.