New IPR Research: June 2021
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This month's new research from IPR faculty covers how opioid use impacts the hospital system in Illinois, predicting homeowners' gender, and designing a five-question index to measure women's agency. It also examines whether the Check & Connect mentorship program in Chicago Public Schools improves attendance and academic outcomes, why people still read newspapers, and how baby-friendly community initiatives influence breastfeeding.
Social Disparities and Health
Hospital Care for Opioid Use in Illinois
While opioid overdose deaths have received a great deal of attention, there are fewer studies of the effect of the opioid crisis on the hospital system. In the Journal of Behavioral Health Services & Research, community health scholar and IPR associate Joe Feinglass and his colleagues examine the impact of opioid use on hospitals in Illinois. The researchers looked at data for 214 Illinois hospitals between Jan. 2016–June 2019 for all inpatient and emergency department (ED) visits. They coded ED visits by use, abuse, dependence, or overdose of opioids and matched patient Zip codes to Census data to find out patients’ area poverty level. There were over 239,000 opioid-related hospital visits during the 42 months, over 60% of which were by men. Cook County, with 40% of the state’s population, had 60% of all opioid hospital visits. White Illinoisans, who account for 70% of the population, made up 45% of visits, while Black Illinoisans, who account for 14% of the population, made up 37% of all visits. The ED visit rate was more than six times higher in the highest poverty areas than in the most affluent areas, and the death rate was five times higher. In total, there was nearly $5 billion in charges for hospital visits related to opioid use—over three quarters paid by public insurance—and Illinois patients with opioid use disorder spent 710,884 days in the hospital. To address the opioid crisis, the researchers recommend decriminalization of drug use, limits on opioid prescriptions for chronic pain, increased access to safe syringes, take-home naloxone and safe consumption sites, and better financing for medically assisted treatment and wrap around social services.
Quantitative Methods for Policy Research
Predicting Homeowners' Gender
Homeownership is an essential tool to building wealth, but who owns a home? In Population Research and Policy Review, IPR sociologist Julia Behrman and Doron Shiffer-Sebba note that shared ownership between married couples is an assumption in most surveys, creating higher joint ownership estimates and misleading patterns in wealth. To get a clearer picture of who actually holds wealth in the form of homeownership, the researchers apply gender R’s algorithms to distinguish gender through names based on data from the Social Security Administration. They examined 257,764 properties from tax assessor data in Detroit and Philadelphia and combined the data with Census Zip code-level data from 2013–2017 American Community Survey 5-year estimates to examine race, marriage status, education, and income. The researchers categorized homeownership by female-sole owners, male-sole owners, mixed ownership, or other, which meant more than two owners or owners of the same gender. Female-sole owners were the largest category in Detroit (49%) and Philadelphia (36%), and mixed male-female ownership was the lowest in Detroit (12%) and somewhat lower in Philadelphia (33%). Even though the researchers found more female owners, women were more likely to own smaller and lower-value homes than males. In Philadelphia, women also tend to be in Zip codes with lower education and fewer high earners. The results provide new insights into understanding wealth and homeownership by highlighting gender differences, specifically that more women, not couples, own homes.
Designing a Five-Question Women's Agency Index
Measuring women’s agency—their ability to make choices and act on them—is key to research and policy related to gender equality. Although long survey measures of women’s agency exist, IPR economist Seema Jayachandran and her colleagues developed a shorter, five-question measure. They used a new method that combines machine learning and semi-structured interviews, which they tried in Haryana, India, and explain in an IPR working paper. The researchers collected 63 possible questions from existing surveys, such as the Demographic and Health Surveys and the Relative Autonomy Index. They also developed an interview guide that covered six areas of women’s agency: education, fertility, mobility, health, employment, and household spending. The survey and interviews were administered in Haryana, an area the researchers chose because of its large gender gaps, to 209 women from 21 villages from February–May 2019. To identify the best survey questions, the researchers used statistical analyses based on machine learning to eliminate all but five questions. These best questions were selected because the answers to them strongly predict the qualitative score obtained from the interviews. The top questions asked about a woman’s role in specific buying decisions, her mobility, and her children’s healthcare. The five-question module is a valuable new resource for measuring women’s agency and the new method may contribute to the development of a valid measure for other places and other complex concepts.
An Intervention to Improve Attendance and Academic Outcomes
Does mentoring improve a student’s attendance and academic outcomes? In the Journal of Policy Analysis and Management, IPR economist Jonathan Guryan and his co-authors ran a randomized controlled trial (RCT) on a mentoring program in Chicago Public Schools called Check & Connect (C&C) to examine the effects on attendance and academic outcomes. The researchers randomized the sample by schools, grades, and students. There was also a control group to determine whether the program affected students attending the same school as the intervention but not in the program. C&C mentors met individually with students or in small groups about five times a month, more often for students the mentors thought needed additional support, and had informal check-ins with students during recess and other school environments. Guryan and his colleagues determined that student absences in grades 5–7 decreased by 4.2 days or 22.9%, but the intervention did not improve student attendance in grades 1–4. In addition, the researchers did not find statistically significant effects on test scores or GPA or any detectable spillovers to other students in the schools where the program took place. The authors suggest that C&C may significantly impact older youth because older children have more control over school attendance decisions. While the researchers estimate that C&C costs about $400 per day of improved attendance, they argue higher-cost interventions like this one may be necessary to make more substantial improvements in attendance.
Politics, Institutions, and Public Policy
Why Do People Still Read Print Newspapers?
How and why do people still get print newspapers in an era dominated by digital access to the news? In New Media & Society, media scholar and IPR associate Pablo Boczkowski and his colleagues examine this question by taking a non-media centric approach, or looking at the way consuming media and everyday life intertwine, and focus on how access, sociality, and ritualization play into reading print newspapers. The researchers study 488 semi-structured in-person interviews about the consumption of news, entertainment, and technology conducted by local interviewers in Argentina, Finland, Israel, Japan, and the United States between March 2016 and February 2019. While these countries have geographic, language, and cultural differences, they all are democracies and have high rates of Internet access. The researchers find that access to print newspapers ranged from free newspapers in public in Israel to interviewees who paid for multiple newspapers in Japan. In many of the countries, social relationships played a role in receiving a newspaper as family members passed on print newspapers to a spouse or child. Many interviewees ritualized reading the newspaper as part of their daily activities, such as always reading it during their commute. The researchers argue that taking a non-media centric approach to understand why people still read newspapers allows scholars to analyze the persistence of older media during an age dominated by new media and the role of print newspapers in everyday life.
Child, Adolescent, and Family Studies
Baby-Friendly Community Initiative and Breastfeeding Among Mothers
Exclusive breastfeeding is one of the most effective ways to increase child survival, but rates are often low among women living with HIV. In a study in rural Kenya led by Betty Samburu, formerly of the Ministry of Health in Kenya, IPR anthropologist Sera Young and her colleagues investigated the effectiveness of a program to support women and their infants to exclusively breastfeed called “Baby-Friendly Communities Initiatives.” This intervention builds off of the well-known Baby-Friendly Hospital Initiative but works to change knowledge and attitudes toward exclusive breastfeeding outside the hospital. The researchers conducted a randomized control trial between April 2015–December 2016 among 901 pregnant women—both HIV positive and negative—across 13 community units. Women in the six intervention groups received 12 home-based counseling sessions following Baby-Friendly Community Initiative (BFCI) guidelines for breastfeeding during pregnancy and until their infant was 6-months old. Community health volunteers conducted the training. Women in the seven control groups received standard health education once a month while pregnant and breastfeeding, but with no focus on the BFCI breastfeeding guidelines. After six months, exclusive breastfeeding rates were significantly higher among HIV-negative mothers in the BFCI inventions group compared to the control group. Exclusive breastfeeding was higher among HIV-positive women compared to HIV-negative women in the intervention group at four and six months postpartum. While exclusive breastfeeding rates decreased as infants got older, they decreased less in the intervention groups, suggesting BFCI guidelines are an important tool for new mothers. The results highlight the need for continued breastfeeding support outside the hospital.
Photo credits: Pexels and Unsplash
Published: June 23, 2021.