Madonna Harrington Meyer

Care Work Invisible Civic Engagement

Scholars who debate the cause of and solutions for the decline in civic engagement have suggested that Americans have increasingly withdrawn from community organizations, reducing their political activity such as voting and interest in the political world, and generally failing to place the common good over individual self-interest. Their analyses are steeped in a tradition that is largely gender blind and consequently ignores care work. We infuse feminist analyses of paid labor and citizenship, which emphasize the merits and burdens of care work, into the civic engagement debate. We argue that care work, predominantly performed by women, paradoxically limits, enhances, and even constitutes a vital form of civic activity. We call for a fuller slate of social policies that will both redistribute the burden of care work and reinvigorate civic engagement.

Old age and the search for security : an American social history

Preface Introduction: Historians and the History of Old Age in America 1. The Families of the Old 2. Wealth and Poverty: The Economic Well-Being of the Aged 3. Work and Retirement 4. The Threat of the Almshouse 5. Advice to the Old 6. A New History of Old Age Notes Index

Family Status and Poverty among Older Women: The Gendered Distribution of Retirement Income in the United States

While the elderly in general enjoy improved economic status, older women continue to face disproportional impoverishment; nearly three-fourths of the elderly poor in the United States are women. A review of U.S. and British feminist writing suggests that old-age income schemes are gendered in three key ways: (1) retirement income is linked to waged labor, which is itself gendered; (2) non-waged reproductive labor, performed predominantly by women, is not recognized as labor; and (3) family status is conceptualized as permanent rather than transient. The supposedly gender-neutral eligibility and benefit structures of three major U.S. retirement income programs—Social Security, private pensions, and personal pensions such as Individual Retirement Accounts— are examined to show how they produce a gendered distribution of old age income.

Family, work, and access to health insurance among mature women

We use a life course approach to address much ignored variation in access to health insurance. Using data from the National Longitudinal Survey of Mature Women, we reinterpret the role of both family and employment characteristics in shaping coverage. Mature women are more likely to be insured as wives than as workers, but that safety net is only available to married women. As a result, unmarried women are two to three times as likely to be uninsured or to rely on public programs such as Medicaid. And because they are significantly less likely to be married to a covered worker, Black women are two to three times more likely to be uninsured or to rely on public programs. Given rising instability in employment and marital status across the life course, stable health insurance coverage can only be attained by universal rather than employment-based or family-based schemes.

THE POLITICS OF REPRODUCTIVE BENEFITS U.S. Insurance Coverage of Contraceptive and Infertility Treatments

Recent changes in access to contraceptive and infertility treatments in the state of Illinois, and across the United States more generally, have heightened class cleavages in access to reproductive health care benefits in the United States. Using data gleaned from government testimonies, public documents, and telephone interviews, the authors found that poor women have broad access to contraceptive coverage but very little access to infertility treatments, while working-and middle-class women have increasingly broad coverage of infertility treatments but spare coverage of contraceptives. These findings suggest that while the extreme measures of the eugenics movement are less frequently in evidence, class differences in access to reproductive services lead to an equally dualistic, albeit unstated, fertility policy in the United States: encouraging births among working- and middle-class families and discouraging births among the poor, particularly those on Medicaid.

Declining Eligibility for Social Security Spouse and Widow Benefits in the United States

Currently, two thirds of older women receive Social Security spouse and widow benefits, which are distributed on the basis of marital rather than employment status. But marriage rates are down, particularly among Black women. This study used June 1985, 1990, and 1995 Current Population Survey data to trace trends in marriage for women from five birth cohorts and to predict marital patterns for the latter three cohorts. The authors found that the proportion of women who will reach age 62 without 10-year marriages, and thus be ineligible for spouse and widow benefits, is increasing modestly for Whites and Hispanics but dramatically for African Americans. When women who were born in the 1960s reach age 62, 82% of Whites, 85% of Hispanics, and just 50% of Blacks will be eligible. The authors discuss alternative mechanisms for distributing benefits.

Medicaid Reimbursement Rates and Access to Nursing Homes: Implications for Gender, Race, and Marital Status

Medicaid reimbursement rates vary widely around the country and at times are just 70 to 80 percent of prevailing private pay rates. These differences may create economic incentives for nursing homes to discriminate against Medicaid applicants. The 1997 National Nursing Home Survey of Current Residents provides the opportunity to develop a ratio of Medicaid to private pay rates for a nationally representative sample of 6,081 residents. Logistic regression modeling shows that even when controlling for sex, race, marital status, and functional level, residents are less likely to be on Medicaid at admission when the ratio is small than when it is close to 1.0. Older Blacks and Hispanics, and older unmarried persons, are more likely to be on Medicaid; therefore, they are more likely to face delay or denial of admission. A possible policy resolution comes from Minnesota, where an equalization law requires nursing home and welfare state officials to work together to set rates, making discriminatory practices against vulnerable groups illegal.

GENDER, RACE, AND THE DISTRIBUTION OF SOCIAL ASSISTANCE: Medicaid Use Among the Frail Elderly

Class-based theories of the welfare state suggest that welfare states stratify by social class, thus universal benefits are praised for fostering social equality and class solidarity whereas poverty-based benefits are criticized for fostering greater inequality and class conflict. Feminist theorists suggest that, in addition to social class, universal and poverty-based benefits are organized around dimensions of gender and race. I examine these arguments in conjunction with old-age reliance on Medicaid—the poverty-based long-term care system in the United States. Compared to white men, older Blacks, Hispanics, and women of all races have greater long-term care needs and fewer economic resources with which to meet those needs. Even when differences in income, education, age, marital status, and nursing home use are taken into account, gender and race are significantly related to Medicaid use. As Medicaid recipients, Blacks, Hispanics, and women of all races disproportionately face persistent poverty and discrimination. Even when they are not Medicaid beneficiaries, these groups are particularly likely to suffer other consequences of a poverty-based long-term care system related to state variations in coverage, informal care giving, and spousal impoverishment.

Gender, aging, and social policy

Publisher Summary The US has undergone substantial social and demographic changes over the last several decades, and many of the gender gaps have narrowed. This chapter reviews the theoretical, empirical, and policy-related research on gender differences in old age in the US. It summarizes two key socio-demographic trends—changes in marriage and care work—that shape gender differences in old age. It then examines gender differences in income and health, and explores the degree to which these are addressed by current old age policies in the US. Two key factors, increases in single parenting and the increasing intensity of unpaid care work, continue to shape gender inequality across the life course and well into old age. Gender differences in health, and in access to various types of health benefits, vary significantly across the life course. Finally, this chapter evaluates some policy solutions that could reduce gender inequality in old age. When analyzing gender inequality, old age scholars tend to highlight how social and economic factors constrain individual actions across the life course. Old age scholars will continue to analyze how the recent emphasis on cutting costs and on privatizing public benefits has overshadowed policy proposals that have the potential to make existing programs more responsive to changing social and demographic trends.

Organized Labor, State Structures, and Social Policy Development: A Case Study of Old Age Assistance in Ohio, 1916-1940

In attempting to explain the relative underdevelopment of the American welfare state, one theory, based on a class conflict model, attributes the lack of comprehensive social benefits to the weakness of the labor movement. The state-centered approach, by contrast, locates social program development in aspects of state structures: party competition, autonomous activity of party officials and state bureaucrats, and state organizational structure. This historical case study of the initiation and implementation of old age assistance in Ohio demonstrates that neither a class conflict nor a state-centered model can adequately explain the development of American welfare programs. Old age assistance was shaped through the complex intersection of class and political factors involving different factions of the labor movement, party politics, and an expanding federal bureaucracy.