Robert B. Nielsen

The Communication Patterns Questionnaire-Short Form: A Review and Assessment

The Communication Patterns Questionnaire—Short Form (CPQ-SF) is an 11-item self-assessment of spouses’ perceptions of marital interactions. A cited reference review of the CPQ-SF literature revealed no formal assessment of its psychometric properties and that researchers are imprecise in their use, reporting, and referencing of the measure. Toward improving the use of the CPQ-SF in research and practice, the factor structure and psychometric properties of this scale were examined with data collected from a diverse sample of 477 married individuals. Three latent constructs were identified: criticize/defend, discuss/avoid, and positive interaction patterns. Suggestions for a more precise use of the CPQ-SF in research and practice conclude the article.

Consumer Finances of Low-Income Families

Serious challenges face families at the bottom of the economic ladder. The difficulties of balancing low incomes against expenditures are exacerbated by a lack of assets and insurance. We examine patterns of family asset ownership and health insurance coverage rates. A review of research focuses on selected dimensions of the financial environment of low-income families: the phenomena of the “unbanked,” home ownership trends, credit use and predatory lending. In each of these areas, additional research is needed to identify ways to help families not only meet their needs, but also to accumulate assets that promote long-term economic well-being.

Transportation Access: A Key Employment Barrier for Rural Low-Income Families

Findings from three sequential studies build an understanding of the transportation barriers facing poor rural families and the link between transportation access and economic outcomes. An in-depth, longitudinal qualitative study explored multiple dimensions of the role of transportation in family life. The results of this study yielded emergent themes and hypotheses used in the subsequent studies. The second study used multiple methods to analyze Census data, vehicle registration lists, and focus group interviews to identify transportation resources in a rural county and to assess transportation needs and barriers facing welfare recipients. The third study addressed the association between transportation and economic outcomes using a dual frame household survey in a cluster of five counties. The article concludes that although policies to provide access to transportation services for rural families may enhance employment opportunities, other related outcomes and longer term effects require additional study.

Health Insurance Stability and Health Status: Do Family-Level Coverage Patterns Matter?

Being uninsured affects ones ability to access medical services and maintain health. Using longitudinal data from the Survey of Income and Program Participation, the authors investigated how individual and family insurance coverage affects adult health. They found that health insurance coverage often varies across family members and changes frequently. Employing multivariate analyses that control for personal insurance status, predisposing characteristics, and enabling resources, the authors show that adults who are members of families that include other uninsured members are more likely to report poor health than adults in full-coverage families. Policy makers should consider refocusing public and private insurance coverage goals to include full-family coverage.

Genetic Testing and the Demand for Cancer Insurance

There has been an expansion of the availability of disease-specific insurance policies in the United States over the past decade. At the same time, recently developed medical tests are providing consumers with new information regarding their risk of contracting particularly serious diseases. This exploratory study makes use of data from two groups of women to examine the demand for one type of disease-specific policy, cancer insurance. Members of the first group have been tested for a BRCA1 gene mutation that is associated with an 88% risk of contracting breast and/or ovarian cancer by age 70. The other group consists of women from the general population who have not been tested for any BRCA1 gene mutation.The study results indicate that women who have been tested for the BRCA1 gene mutation are more likely than untested respondents to have purchased cancer insurance and to have recently thought about purchasing cancer insurance. The results also indicate that older women and women who have modest household incomes are more likely to have purchased cancer insurance. Women who have minor children, who are more highly educated, who have no health insurance, who have had cancer, or who report that they are in poor health are more likely to have recently contemplated purchasing cancer insurance. Our discussion of the findings highlights several issues that merit further consideration on the part of consumer policy makers working in the area of insurance regulation.