Abstracts

"Trends in Lung Surgery, United States 1988 to 2002." Chest, vol. 130, November 2006, Stavros G. Memtsoudis, Melanie C. Besculides, Lambros Zellos, Namrata Patil, and Selwyn O. Rogers. The authors examine temporal changes in the demographics of lung resections by analyzing nationally representative data collected for the National Hospital Discharge Survey from 1988 to 2002. Changes in the prevalence of procedures, age, gender, race, length of care, mortality, disposition status, and distribution by hospital size were evaluated, and trends in procedure-related complications were analyzed. The authors note increases in the average age, proportion of patients who were female, and proportion of Medicare/Medicaid patients. Decreases in the average length of stay and in the proportion of patients discharged to their primary residence were also observed. These findings may help in the development of policies to address the changing needs of and financial burdens on the health care system.

"Do Determinants of Medicare Supplemental Coverage Choice Vary by Income?" Journal of Health & Social Policy, vol. 22, 2006, Erin Fries Taylor, Michael Chernew, and Catherine McLaughlin. Using data from the Community Tracking Study Household Survey (1998-1999), the authors estimate the relationship between Medigap premiums and senior Medicare beneficiaries’ supplemental coverage decisions. All seniors are more likely to be enrolled in an HMO in markets with higher Medigap prices. Lower-income seniors are particularly sensitive to Medigap premiums and more likely to have no supplemental coverage when faced with higher Medigap premiums. As Medicare supplemental options evolve in response to the 2003 Medicare Modernization Act, lower-income beneficiaries may respond to price changes and other factors differently than their higher-income counterparts.

"Parent and Teacher Mental Health Ratings of Children Using Primary-Care Services: Interrater Agreement and Implications for Mental Health Screening." Ambulatory Pediatrics, November 2006, Jonathan Brown, Lawrence Wissow, Anne Gadomski, Clara Zachary, Edward Bartlett, and Ivor Horn. Mental health screening in pediatric primary care settings has become a more common practice to improve the identification and treatment of child mental health problems. This article examines agreement between parents and teachers in their ratings of the mental health of children using primary care. Parents and teachers rarely identified the same child as having mental health problems, and parents failed to detect 52 percent of children the teacher identified as seriously disturbed. The results suggest that screening in primary care may require the development of algorithms to help providers judge when to solicit information from teachers, and that providers need skills to interpret conflicting information from parents and teachers.

“Maternal Feeding Strategies, Child Eating Behaviors, and Child BMI in Low-Income African American Preschoolers.” Obesity, November 2006, Scott W. Powers, Leigh A. Chamberlin, Kelly B. van Schaick, Susan N. Sherman, and Robert C. Whitaker. The increasing prevalence of obesity in pediatric populations has prompted greater interest in the relationships among parent feeding practices, children’s eating behaviors, and parent and child weight status. This article found that among low-income African Americans, the positive association between maternal restriction and control in feeding and their preschoolers’ body mass index was limited to obese mothers. Relations between parent feeding strategies and child weight status in this population may differ on the basis of maternal weight status.

"Informed Participation in TennCare by People with Disabilities." Journal of Health Care for the Poor and Underserved, November 2006, Steven C. Hill and Judith Wooldridge. Informed consumer participation in health care is increasingly important, but people with disabilities face barriers to making health care decisions. Using a unique survey, we examine informed health care choices by nonelderly people with diverse disabilities, including mental retardation, mental illness, visual and hearing impairments, and difficulty communicating, in TennCare, Tennessee's Medicaid managed care program. Most people with disabilities chose their plans and providers, felt they had enough information to choose a plan, and rated information from their providers as good to excellent. A minority did not know they could choose their plans and providers and reported poor or fair communication with providers. Adults with mental retardation were less likely than other adults with disabilities to seek information. Adults with serious difficulty communicating were less satisfied than others with information from providers. Medicare, Medicaid, health plans, and providers should tailor information dissemination to the diverse needs of people with disabilities. Reprints available while supply lasts; call 609-275-2350.

“Commercial Health Insurance: Smart or Simply Lucky?” Health Affairs, November 2006, Marsha Gold. Changes in the commercial health insurance industry are less a strategic shift than a defensive reaction to forces the industry cannot control, and risky opportunities the industry cannot pass up. Diversification into the public sector presents short-term gains for the insurance industry but leaves unchanged the fundamental challenge it faces: rapid and apparently uncontrollable growth in health care costs. This article notes that commercial insurers have not proved to be any better than public payers at controlling costs. Unless the drivers of health care cost are tamed, the main benefits that people seek from insurance—stable coverage and financial protection—will erode further.

“Gender Gaps in College and High School Graduation by Race, Combining Public and Private Schools.” Education Working Paper Archive, November 2006, Duncan Chaplin and Daniel Klasik. Each year, the U.S. college system grants twice as many bachelor’s degrees to African American females as males. Large gender gaps favoring women also exist for other groups—on average, our college system awards 35 percent more B.A.s to females than males across all racial and ethnic groups. Traditional explanations for this situation have focused on what happens in college. In this brief, the authors note that at least part of the explanation can be traced to differences in high school graduation rates. Although differences in high school graduation rates are far smaller than differences in college rates, variations by race and gender follow the same patterns. High schools are graduating about 23 percent more African American females than males each year, and the authors’ estimates suggest about a 4 percent difference that favors females across all ethnic groups.

“Dietary Effects of Universal-Free School Breakfast: Findings from the Evaluation of the School Breakfast Program Pilot Project.” Journal of the American Dietetic Association, November 2006, Mary Kay Crepinsek, Anita Singh, Lawrence S. Bernstein, and Joan E. McLaughlin. This article reports on an experimental study to determine the effects on students’ dietary outcomes of offering universal-free school breakfast in elementary schools. Treatment schools offered free breakfasts to all students regardless of family income. Schools participating in the federal School Breakfast Program (SBP), which offers free or reduced-price breakfast for children from families below the poverty level, served as controls. More than 4,000 students in grades 2 through 6 provided 24-hour dietary recall data at the end of the first year. Despite a significant increase in school breakfast participation among students in treatment schools (from 16 percent to 40 percent), the rate of breakfast skipping did not differ between groups (4 percent overall). Treatment school students were more likely to eat breakfast at school and consume a nutritionally substantive breakfast, but dietary intakes over 24 hours were essentially the same. The authors conclude that making universal-free school breakfast available in elementary schools will not result in more students "breaking their fast" or improving the quality of their diet, beyond any effects of offering the regular SBP. To improve children’s diets overall, efforts should focus on ensuring that all students have access to a healthful breakfast, at home or at school.

“Natives, the Foreign-Born, and High School Equivalents: New Evidence on the Returns to the GED.” Journal of Population Economics, October 2006, Melissa A. Clark and David Jaeger. This article explores the labor market returns to the General Education Development (GED) exam for U.S. natives and the foreign-born. The authors found that foreign-born men with a GED who received all of their formal schooling abroad earn significantly more than either foreign-schooled high school dropouts or graduates. In contrast, among U.S. natives, GED recipients earn less than high school graduates but significantly more than dropouts. The returns for natives become larger over the life cycle and are not due to cohort effects. The findings indicate that the GED may be more valuable in the labor market than some previous research suggests. Reprints available while supply lasts; call 609-275-2350.

"Food Insecurity and the Risks of Depression and Anxiety in Mothers and Behavior Problems in Their Preschool-Aged Children." Pediatrics, vol. 118, no. 3, September 2006, Robert C. Whitaker, Shannon M. Phillips, and Sean M. Orzol. Stressful social circumstances, particularly constrained economic resources, have been linked to behavioral problems in young children and to symptoms of depression and anxiety in mothers. Using data Mathematica collected for the Fragile Families and Child Wellbeing Study, researchers sought to determine if the prevalence of depression and anxiety in mothers and the prevalence of behavior problems in preschool-aged children are more common when mothers report being food insecure. They found that 71 percent of respondents were fully food secure, 17 percent were marginally secure, and 12 percent were insecure. Mental health problems in mothers and behavior problems in their children were twice as likely in food-insecure households, after controlling for multiple factors, including income and other forms of material hardship. Alleviating food insecurity might be one way to enhance the mental and emotional well-being of mothers and their young children.

Back to Top