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The SSRC Library allows visitors to access materials related to self-sufficiency programs, practice and research. Visitors can view common search terms, conduct a keyword search or create a custom search using any combination of the filters at the left side of this page. To conduct a keyword search, type a term or combination of terms into the search box below, select whether you want to search the exact phrase or the words in any order, and click on the blue button to the right of the search box to view relevant results.

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  • Individual Author: Aliprantis, Dionissi; Fee, Kyle; Schweitzer, Mark E.
    Reference Type: Journal Article
    Year: 2019

    This paper studies the relationship between local opioid prescription rates and labor market outcomes. We improve the joint measurement of labor market outcomes and prescription rates in the rural areas where nearly 30 percent of the US population lives. We find that increasing the local prescription rate by 10 percent decreases the prime-age employment rate by 0.50 percentage points for men and 0.17 percentage points for women. This effect is larger for white men with less than a BA (0.70 percentage points) and largest for minority men with less than a BA (1.01 percentage points). Geography is an obstacle to giving a causal interpretation to these results, especially since they were estimated in the midst of a large recession and recovery that generated considerable cross-sectional variation in local economic performance. We show that our results are not sensitive to most approaches to controlling for places experiencing either contemporaneous labor market shocks or persistently weak labor market conditions. We also present evidence on reverse causality, finding that a short-...

    This paper studies the relationship between local opioid prescription rates and labor market outcomes. We improve the joint measurement of labor market outcomes and prescription rates in the rural areas where nearly 30 percent of the US population lives. We find that increasing the local prescription rate by 10 percent decreases the prime-age employment rate by 0.50 percentage points for men and 0.17 percentage points for women. This effect is larger for white men with less than a BA (0.70 percentage points) and largest for minority men with less than a BA (1.01 percentage points). Geography is an obstacle to giving a causal interpretation to these results, especially since they were estimated in the midst of a large recession and recovery that generated considerable cross-sectional variation in local economic performance. We show that our results are not sensitive to most approaches to controlling for places experiencing either contemporaneous labor market shocks or persistently weak labor market conditions. We also present evidence on reverse causality, finding that a short-term unemployment shock did not increase the share of people abusing prescription opioids. Our estimates imply that prescription opioids can account for 44 percent of the realized national decrease in men’s labor force participation between 2001 and 2015. (Author abstract)

  • Individual Author: Skewes, Monica C.; Blume, Arthur W.
    Reference Type: Journal Article
    Year: 2019

    Historians and scholars from various disciplines have documented the pervasive influence of racism on American society and culture, including effects on the health and well-being of American Indian (AI) people. Among the many health problems affected by racial discrimination and oppression, both historical and current, are substance use disorders. Epidemiological studies have documented greater drug and alcohol-related morbidity and mortality among AI/AN Alaska Natives compared to other ethnic groups, and culturally appropriate, effective interventions are sorely needed. We collected, as part of a larger community-based participatory research project to address substance use disparities in rural AI communities, qualitative interview data from 25 AI key informants from a frontier reservation in Montana. Using a semistructured interview guide, we asked participants to discuss their perceptions of the causes of substance use problems and barriers to recovery on the reservation. Although no questions specifically asked about discrimination, key informants identified stress from...

    Historians and scholars from various disciplines have documented the pervasive influence of racism on American society and culture, including effects on the health and well-being of American Indian (AI) people. Among the many health problems affected by racial discrimination and oppression, both historical and current, are substance use disorders. Epidemiological studies have documented greater drug and alcohol-related morbidity and mortality among AI/AN Alaska Natives compared to other ethnic groups, and culturally appropriate, effective interventions are sorely needed. We collected, as part of a larger community-based participatory research project to address substance use disparities in rural AI communities, qualitative interview data from 25 AI key informants from a frontier reservation in Montana. Using a semistructured interview guide, we asked participants to discuss their perceptions of the causes of substance use problems and barriers to recovery on the reservation. Although no questions specifically asked about discrimination, key informants identified stress from racism as an important precipitant of substance use and barrier to recovery. As one participant stated: “Oppression is the overarching umbrella for all sickness with drugs and alcohol.” Participants also identified historical trauma resulting from colonization as a manifestation of race-based stress that drives behavioral health problems. Findings suggest that interventions for AIs with substance use disorders, and possibly other chronic health problems, may be more effective if they address social determinants of health such as racial discrimination and historical trauma. (Author abstract)

  • Individual Author: Woolf, Steven H.; Aron, Laudan
    Reference Type: White Papers
    Year: 2018

    White Americans are dying at higher rates from drugs, alcohol, and suicides. And the sharpest increases are happening in rural counties, often in regions with long-standing social and economic challenges. The reasons behind these increases are unclear and complex. The opioid epidemic plays a role but is just one part of a larger public health crisis. Life expectancy in the US as a whole has fallen for the second year in a row, and the nation’s health relative to other countries has been declining for decades. Some combination of factors in American life must explain why the rise in mortality is greatest among white, middle-aged adults and certain rural communities. Possibilities include the collapse of industries and the local economies they supported, greater social isolation, economic hardship, and distress among white workers over losing the security their parents’ generation once enjoyed. Also, over the past 30 years, income inequality and other social divides have widened, middle-class incomes have stagnated, and poverty rates have exceeded those of most rich countries.  ...

    White Americans are dying at higher rates from drugs, alcohol, and suicides. And the sharpest increases are happening in rural counties, often in regions with long-standing social and economic challenges. The reasons behind these increases are unclear and complex. The opioid epidemic plays a role but is just one part of a larger public health crisis. Life expectancy in the US as a whole has fallen for the second year in a row, and the nation’s health relative to other countries has been declining for decades. Some combination of factors in American life must explain why the rise in mortality is greatest among white, middle-aged adults and certain rural communities. Possibilities include the collapse of industries and the local economies they supported, greater social isolation, economic hardship, and distress among white workers over losing the security their parents’ generation once enjoyed. Also, over the past 30 years, income inequality and other social divides have widened, middle-class incomes have stagnated, and poverty rates have exceeded those of most rich countries.  Recent legislation and regulations, however, may prolong or intensify the economic burden on the middle class and weaken access to health care and safety net programs. The consequences of these choices are dire—not only more deaths and illness, but also escalating health care costs, a sicker workforce, and a less competitive economy. (Author abstract) 

  • Individual Author: Ghertner, Robin; Baldwin, Melinda; Crouse, Gilbert; Radel, Laura; Waters, Annette
    Reference Type: Report
    Year: 2018

    This research brief describes how select indicators associated with substance use prevalence relate to the changing trend in child welfare caseloads. It is part of a series describing findings of a mixed methods study undertaken to better understand how parental substance use relates to child welfare caseloads, which began rising in 2012 following years of sustained declines. (Author abstract)

    This research brief describes how select indicators associated with substance use prevalence relate to the changing trend in child welfare caseloads. It is part of a series describing findings of a mixed methods study undertaken to better understand how parental substance use relates to child welfare caseloads, which began rising in 2012 following years of sustained declines. (Author abstract)

  • Individual Author: Monnat, Shannon M.
    Reference Type: Journal Article
    Year: 2018

    Over the past 2 decades, drug-related deaths have grown to be a major U.S. public health problem. County-level differences in drug-related mortality rates are large. The relative contributions of social determinants of health to this variation, including the economic, social, and healthcare environments, are unknown.

    Using data from the U.S. Centers for Disease Control and Prevention Multiple-Cause of Death Files (2006–2015, analyzed in 2017); U.S. Census Bureau; U.S. Department of Agriculture Economic Research Service; Agency for Healthcare Research and Quality; and Northeast Regional Center for Rural Development, this paper modeled associations between county-level drug-related mortality rates and economic, social, and healthcare environments. Spatial autoregressive models controlled for state fixed effects and county demographic characteristics.

    The average county-level age-adjusted drug-related mortality rate was 16.6 deaths per 100,000 population (2006–2015), but there were substantial geographic disparities in rates. Controlling for county demographic...

    Over the past 2 decades, drug-related deaths have grown to be a major U.S. public health problem. County-level differences in drug-related mortality rates are large. The relative contributions of social determinants of health to this variation, including the economic, social, and healthcare environments, are unknown.

    Using data from the U.S. Centers for Disease Control and Prevention Multiple-Cause of Death Files (2006–2015, analyzed in 2017); U.S. Census Bureau; U.S. Department of Agriculture Economic Research Service; Agency for Healthcare Research and Quality; and Northeast Regional Center for Rural Development, this paper modeled associations between county-level drug-related mortality rates and economic, social, and healthcare environments. Spatial autoregressive models controlled for state fixed effects and county demographic characteristics.

    The average county-level age-adjusted drug-related mortality rate was 16.6 deaths per 100,000 population (2006–2015), but there were substantial geographic disparities in rates. Controlling for county demographic characteristics, average mortality rates were significantly higher in counties with greater economic and family distress and in counties economically dependent on mining. Average mortality rates were significantly lower in counties with a larger presence of religious establishments, a greater percentage of recent in-migrants, and counties with economies reliant on public (government) sector employment. Healthcare supply factors did not contribute to between-county disparities in mortality rates.

    Drug-related mortality rates are not randomly distributed across the U.S. Future research should consider the specific pathways through which economic, social, and healthcare environments are associated with drug-related mortality. (Author abstract)

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