Publications
Dietary Reference Intakes
 “Review of the Dietary Reference Intakes for Selected Nutrients: Application Challenges and Implications for Food and Nutrition Assistance Programs.” Barbara Devaney, Mary Kay Crepinsek, Ken Fortson, and Lisa Quay, November 2006. Dietary Reference Intakes (DRIs) are the most recent set of nutrient-based reference standards, which, together with recommended dietary assessment methods, are used to update estimates of nutrient adequacy for population subgroups. Recent estimates suggest both dietary deficiencies and excesses for selected nutrients among some subgroups. This report takes a critical look at the methods used to set DRIs for energy and six nutrients—zinc, vitamin A, magnesium, vitamin E, fiber, and potassium. It suggests that errors in dietary recall data may partially explain the deficiencies and excessive intakes. In addition, DRIs for selected nutrients may be based on less than optimal data. Because food and nutrition assistance programs use DRIs to set nutritional objectives, establish benefits, and evaluate outcomes, it is important to understand the issues involved in deriving the DRIs and how to interpret the results of dietary assessments.
|
Health Care Disparities
 “Effect of Medicaid Managed Care on Racial Disparities in Health Care Access.” Benjamin Cook, Health Services Research, February 2007. This article evaluates the impact of Medicaid managed care on racial disparities in access to care. It uses the Institute of Medicine definition of racial disparity, which excludes differences stemming from health status but includes differences mediated by socioeconomic status. Enrollment is associated with lowered disparities in having any doctor visit in the past year for blacks, and in having any usual source of care for both blacks and Hispanics. To address selection issues, the author also looked at the effect of Medicaid HMO market share on disparities. Increased Medicaid HMO market share lowered disparities in having any doctor visits in the past year for both blacks and Hispanics. On a less positive note, blacks used the ER more than whites in areas of high Medicaid HMO market share. The reduction of some disparities suggests that recent shifts in Medicaid policy toward managed care plans have benefited minority enrollees.
|
Health Insurance Coverage
 “Immigrants and Employer-Sponsored Health Insurance.” Thomas C. Buchmueller, Anthony T. Lo Sasso, Ithai Lurie, and Sarah Dolfin, Health Services Research, February 2007. Interest in the health status of immigrant populations has increased dramatically in response to their rapid growth over the past two decades. This study investigated the factors underlying the lower rate of employer-sponsored health insurance for foreign-born workers. The authors found that the substantially higher rate of uninsurance among immigrants is driven by the lower rate of health insurance offered by the employers of immigrants, rather than by differences in eligibility or take-up.
|
Personal Reemployment Accounts
 “Implementing Personal Reemployment Accounts (PRAs): Early Experiences of the Seven Demonstration States.” Gretchen Kirby, September 2006. PRAs are a new strategy to help recipients of unemployment insurance build job skills and find work. PRAs combine individually managed accounts and bonuses of up to $3,000 for reemployment, to give unemployed workers flexibility in devising their own reemployment plan. This interim report highlights implementation experiences of PRA demonstration sites in seven states—Florida, Idaho, Minnesota, Mississippi, Montana, Texas, and West Virginia. Early findings show that states have maintained a high degree of flexibility and customer choice in the use of PRAs by placing limited, if any, restrictions on recipients’ selection of training providers. States have also allowed recipients to purchase a broad range of supportive services that help sustain a job search. The analysis suggests that PRA recipients will restrict spending on services to maximize the amount of a reemployment bonus. But, when funds are used to purchase services, the majority of spending is directed to supportive services in five of the seven states.
|
Special Care for Special Kids
 “Coordinating Care for Children with Special Health Care Needs.” Quality Care for Special Kids: Profiles of Children with Chronic Conditions and Disabilities #4. Stephanie Peterson, Shanna Shulman, and Henry Ireys, January 2007. This brief, the fourth in a series on critical issues involved in caring for children with special health care needs, notes that nearly three-quarters of parents who need professional care coordination services for their child say they do not get enough help—if they get any at all. Moreover, one-third of those who do get help are not fully satisfied with the quality of services they receive. Although many health plans coordinate care for their adult members with chronic conditions and disabilities, few do so for children. The brief provides suggested steps that plans can take to improve care coordination for these children.
|
On the Move: Staff News
 Amy Johnson, director of Princeton Survey Research, has been named vice president. She is an expert in issues related to at-risk youth and teaching and learning.
|
|
|
|
|
