Youth Risk Behavior
 “Social Status, Stress, and Adolescent Smoking.” Daniel M. Finkelstein, Laura D. Kubzansky, and Elizabeth Goodman, Journal of Adolescent Health, November 2006. Lower social status and greater stress have been linked to increased risk of smoking among youth, but previous studies have not fully explored the relations among social status, stress, and smoking risk. This article reports on a study that examined whether perceived stress accounts for the observed association between social status and smoking. Findings indicate that both higher stress and lower social status increase risk of smoking among youth, but that stress does not account for the association between lower social status and smoking. This suggests that stress reduction interventions may not alleviate social inequalities in teen smoking, but they still hold promise for youth smoking prevention.
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Consumer Direction in Florida
 “Consumer and Consultant Experiences in the Florida Consumer Directed Care Program.” Leslie Foster, Barbara Phillips, and Jennifer Schore, June 2005. The Cash and Counseling demonstration and evaluation, implemented in Arkansas, Florida, and New Jersey, gave eligible Medicaid beneficiaries who were frail or had disabilities the opportunity to receive a monthly allowance to purchase supportive services of their choosing. This report describes the implementation of Florida’s Consumer Directed Care program. Florida was the only demonstration state to target people with primarily developmental disabilities, and the only state to enroll children. The data analysis of discussions with program staff, consultant questionnaires, and consumer surveys shows that Florida’s CDC program is worthwhile from a consumer perspective and feasible from an administrative one. In terms of enrollment, retention, and satisfaction, the program was most attractive to the families of children with developmental disabilities and least attractive to the frail elderly.
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Employment of People with Disabilities
 The following articles appeared in a special issue of the Journal of Vocational Rehabilitation, vol. 25, no.1, 2006, focusing on spinal cord injury (SCI).
“Vocational Rehabilitation Services for Individuals with Spinal Cord Injury.” Michelle A. Meade, Amy J. Armstrong, Kirsten Barrett, Phyllis S. Ellenbogen, and M. Njeri Jackson. Employment brings many benefits but is often unavailable, inaccessible to, or underutilized by individuals with SCI and other significant physical disabilities. Vocational rehabilitation services can provide assistance in obtaining employment; however, the extent that these services are accessed, desired, or valued by individuals with SCI is unknown. This article reports on a survey of individuals with SCI in Virginia. Approximately 32 percent of respondents reported receiving at least one job-related service, the most frequent of which was vocational counseling (20 percent). No gender differences were found between individuals who did and did not receive services. Racial differences were found, with nonwhites more likely to have received services. Respondents most frequently reported an interest in receiving assistance with developing a new job skill (24 percent), assistance with finding a job (21 percent), and retirement planning (19 percent).
“Work Intensity and Variations in Health and Personal Characteristics of Individuals with Spinal Cord Injury.” Michelle A. Meade, Kirsten Barrett, Phyllis S. Ellenbogen, and M. Njeri Jackson. This article describes the relationship between work intensity, personal and injury-related factors, and the resources typically associated with employment, including insurance, access to health care, and salary. No significant differences were found with regard to gender or pre-injury employment status between individuals with SCI who were not working, those employed part-time, and those employed full-time. Significant differences were noted between groups with regard to race, marital status, total number of medical problems, receipt of vocational services, and severity of injury. Individuals working full-time were significantly more likely to have dental insurance, less likely to have been unable to get needed medical care, and less likely to have problems with either uncontrolled spasticity or chronic pain in the past 12 months, as compared with the other two groups. Results support the value of employment in providing access to health care and a range of other benefits for persons with SCI. The findings also suggest that secondary conditions may influence the level/intensity of employment for individuals with SCI and that working part-time still provides advantages over unemployment.
“Perspectives on Networking, Cultural Values, and Skills Among African American Men with Spinal Cord Injury: A Reconsideration of Social Capital Theory.” M. Njeri Jackson, Michelle A. Meade, Phyllis Ellenbogen, and Kirsten Barrett. Unemployment among African Americans with SCI poses a serious challenge to successful recovery and community reintegration. Recent research about documented racial disparities in employment following injury is often laden with assumptions about the absence of "social capital," including networks of support, appropriate skills, work ethic, or viable work history profile. Such assumptions inform social policy aimed at assisting the unemployed, including African Americans with SCI, and are embedded in explanations for reducing the role of government in addressing poverty and related social issues. Social capital theory has also been used to justify an increased reliance on nongovernmental networks and institutions (particularly faith-based) to address concerns of individuals and families struggling with employment, health care, or other issues traditionally addressed by the state. This article discusses the attitudes of African American men with SCI toward work and their perceptions of obstacles and supports in their attempts to seek and secure employment in comparison and contrast to explanations presented in social capital theories. The results raise questions about assumptions and policies based in social capital theories and suggest a need to reconsider and reframe explanations for unemployment and those social reintegration strategies embodied in related policies.
“The Impact of Spinal Cord Injury on the Employment of Family Caregivers.” Phyllis S. Ellenbogen, Michelle A. Meade, M. Njeri Jackson, and Kirsten Barrett. This article describes and explores the impact of SCI on the employment of family members, especially those who act as primary caregivers, of individuals with SCI. Four primary themes emerged: (1) caregivers had to create flexibility in their employment situation in order to successfully maintain employment, especially immediately after the injury; (2) while many caregivers felt that they needed to work for financial reasons, there were times when the responsibilities of work and caregiving conflicted; (3) responsibilities left little time for the caregivers to engage in leisure, maintain social connections, spend time with their spouse, or care for their own personal needs; and (4) caregivers' employment was affected by the lack of available certified nursing aides.
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“Poor Preventive Care Achievement and Program Retention Among Low Birth Weight Infant Medicaid Enrollees.”