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Stretched Thin
When the Personal Responsibility and Work Opportunity Reconciliation Act became law in 1996, the architects of welfare reform celebrated what they called the new \"consensus\" on welfare: that cash assistance should be temporary and contingent on recipients' seeking and finding employment. However, assessments about the assumptions and consequences of this radical change to the nation's social safety net were actually far more varied and disputed than the label \"consensus\" suggests.
By examining the varied realities and accountings of welfare restructuring, Stretched Thin looks back at a critical moment of policy change and suggests how welfare policy in the United States can be changed to better address the needs of poor families and the nation. Using ethnographic observations, in-depth interviews with poor families and welfare workers, survey data tracking more than 750 families over two years, and documentary evidence, Sandra Morgen, Joan Acker, and Jill Weigt question the validity of claims that welfare reform has been a success. They show how poor families, welfare workers, and welfare administrators experienced and assessed welfare reform differently based on gender, race, class, and their varying positions of power and control within the welfare state.
The authors document the ways that, despite the dramatic drop in welfare rolls, low-wage jobs and inadequate social supports left many families struggling in poverty. Revealing how the neoliberal principles of a drastically downsized welfare state and individual responsibility for economic survival were implemented through policies and practices of welfare provision and nonprovision, the authors conclude with new recommendations for reforming welfare policy to reduce poverty, promote economic security, and foster shared prosperity.
eBook
Engaging Latino Families About COVID-19 Vaccines: A Qualitative Study Conducted in Oregon, USA
Objectives
Latinos are disproportionately vulnerable to severe COVID-19 due to workplace exposure, multigenerational households, and existing health disparities. Rolling out COVID-19 vaccines among vulnerable Latinos is critical to address disparities. This study explores vaccine perceptions of Latino families to inform culturally centered strategies for vaccine dissemination.
Method
Semistructured telephone interviews with Latino families (22 mothers and 24 youth, 13–18 years old) explored COVID-19 vaccine perceptions including (1) sources of information, (2) trust of vaccine effectiveness and willingness to get vaccinated, and (3) access to the vaccine distribution. We identified thematic patterns using immersion–crystallization.
Results
We found that (1) 41% expressed optimism and willingness to receive the vaccine coupled with concerns about side effects; (2) 45% expressed hesitancy or would refuse vaccination based on mistrust, myths, fear of being used as “guinea pigs,” and the perceived role of politics in vaccine development; (3) families “digested” information gathered from social media, the news, and radio through intergenerational communication; and (4) participants called for community-led advocacy and “leading by example” to dispel fear and misinformation. Optimistic participants saw the vaccine as a way to protect their families, allowing youth to return to schools and providing safer conditions for frontline essential workers.
Conclusions
Culturally centered vaccine promotion campaigns may consider the Latino family unit as their target audience by providing information that can be discussed among parents and youth, engaging a range of health providers and advocates that includes traditional practitioners and community health workers, and disseminating information at key venues, such as schools, churches, and supermarkets.
Journal Article
Emergency temporary standards and COVID-19 trends among Oregon farmworkers
During the COVID-19 pandemic, migrant and seasonal farmworkers were deemed essential due to their central roles in US agricultural operations. However, employer-provided housing and transportation conditions increased their risks of SARS-CoV-2 exposure, and some states implemented emergency temporary standards (ETSs) at the insistence of farmworker advocates. Despite numerous studies examining the effectiveness of policy interventions (e.g., workplace closures) for mitigating SARS-CoV-2 transmission, limited research has specifically examined the effectiveness of interventions aimed at protecting farmworkers from COVID-19.
We used an interrupted time series analysis to estimate how two ETSs and one executive order issued in Oregon impacted COVID-19 trends from March 1, 2020, to February 27, 2021, for the overall population and among agricultural labor groups in Oregon.
Our models show that the ETS and executive order, which specifically targeted farmworker housing, transportation, and worksites, did not demonstrate any significant effects on the numbers of COVID-19 cases or associated deaths. However, the other ETS, which targeted all workplaces, was associated with statistically significant decreases in COVID-19 cases among the general population (-142.36214, p-value<0.0001), producers (-1.67128, p-value = 0.0009), hired workers (-2.39413, p-value = 0.0014), unpaid workers (-1.01572, p-value = 0.0003), and migrant workers (-0.60017, p-value = 0.0166). None of the three policy changes were found to have any statistically significant impacts on the numbers of COVID-19-associated deaths.
The ETS targeting all workplaces was more effective for reducing COVID-19 transmission than the ETS or executive order specifically targeting farmworkers, indicating that the design, communication, and implementation of ETSs targeting farmworkers should be re-evaluated.
Journal Article
Seeing the workers for the trees: exalted and devalued manual labour in the Pacific Northwest craft cider industry
Craft food and beverage makers regularly emphasize transparency about the ethical, sustainable sourcing of their ingredients and the human labour underpinning their production, all of which helps elevate the status of their products and occupational communities. Yet, as with other niche ethical consumption markets, craft industries continue to rely on employment conditions for agricultural workers that reproduce inequalities of race, class, and citizenship in the dominant food system. This paper interrogates the contradiction between the exaltation of craft cidermakers’ labour and the devaluation of farmworker labour by assessing how craft beverage actors make sense of inequalities facing manually skilled agricultural workers. Through a focus on the emerging craft cider industry, this paper draws on in-depth interviews and ethnographic data with a range of urban and rural cider actors in the Pacific Northwest (British Columbia, Oregon, and Washington State). I find that actors in the craft cider industry engage with inequalities affecting farmworkers through three main patterns: (1) Justifications of the status quo; (2) Supply chain fog; and (3) Misgiving/critique. By using an analytical framework that integrates critical agrarianism and the politics of sight, this study provides insights into both barriers and opportunities to redistribute social recognition and material rewards across food supply chains.
Journal Article
Designing and validating a Markov model for hospital-based addiction consult service impact on 12-month drug and non-drug related mortality
Addiction consult services (ACS) engage hospitalized patients with opioid use disorder (OUD) in care and help meet their goals for substance use treatment. Little is known about how ACS affect mortality for patients with OUD. The objective of this study was to design and validate a model that estimates the impact of ACS care on 12-month mortality among hospitalized patients with OUD.
We developed a Markov model of referral to an ACS, post-discharge engagement in SUD care, and 12-month drug-related and non-drug related mortality among hospitalized patients with OUD. We populated our model using Oregon Medicaid data and validated it using international modeling standards.
There were 6,654 patients with OUD hospitalized from April 2015 through December 2017. There were 114 (1.7%) drug-related deaths and 408 (6.1%) non-drug related deaths at 12 months. Bayesian logistic regression models estimated four percent (4%, 95% CI = 2%, 6%) of patients were referred to an ACS. Of those, 47% (95% CI = 37%, 57%) engaged in post-discharge OUD care, versus 20% not referred to an ACS (95% CI = 16%, 24%). The risk of drug-related death at 12 months among patients in post-discharge OUD care was 3% (95% CI = 0%, 7%) versus 6% not in care (95% CI = 2%, 10%). The risk of non-drug related death was 7% (95% CI = 1%, 13%) among patients in post-discharge OUD treatment, versus 9% not in care (95% CI = 5%, 13%). We validated our model by evaluating its predictive, external, internal, face and cross validity.
Our novel Markov model reflects trajectories of care and survival for patients hospitalized with OUD. This model can be used to evaluate the impact of other clinical and policy changes to improve patient survival.
Journal Article