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This volume 39 presents new results on the dynamics of social assistance, minimum-income and related out-of-work benefits in a range of different country contexts.
Poverty remains a pervasive and complex phenomenon in Sub-Saharan Africa. Part of the agenda in recent years to tackle poverty in Africa has been the launching of social safety nets programs. All countries have now deployed safety net interventions as part of their core development programs. The number of programs has skyrocketed since the mid-2000s though many programs remain limited in size. This shift in social policy reflects the progressive evolution in the understanding of the role that social safety nets can play in the fight against poverty and vulnerability, and more generally in the human capital and growth agenda. Evidence on their impacts on equity, resilience, and opportunity is growing, and makes a foundational case for investments in safety nets as a major component of national development plans. For this potential to be realized, however, safety net programs need to be significantly scaled-up. Such scaling up will involve a series of technical considerations to identify the parameters, tools, and processes that can deliver maximum benefits to the poor and vulnerable. However, in addition to technical considerations, and at least as importantly, this report argues that a series of decisive shifts need to occur in three other critical spheres: political, institutional, and fiscal. First, the political processes that shape the extent and nature of social policy need to be recognized, by stimulating political appetite for safety nets, choosing politically smart parameters, and harnessing the political impacts of safety nets to promote their sustainability. Second, the anchoring of safety net programs in institutional arrangements †“ related to the overarching policy framework for safety nets, the functions of policy and coordination, as well as program management and implementation †“ is particularly important as programs expand and are increasingly implemented through national channels. And third, in most countries, the level and predictability of resources devoted to the sector needs to increase for safety nets to reach the desired scale, through increased efficiency, increased volumes and new sources of financing, and greater ability to effectively respond to shocks. This report highlights the implications which political, institutional, and fiscal aspects have for the choice and design of programs. Fundamentally, it argues that these considerations are critical to ensure the successful scaling-up of social safety nets in Africa, and that ignoring them could lead to technically-sound, but practically impossible, choices and designs.
The need for social safety nets has become a key component of poverty reduction strategies. Over the past three decades several developing countries have launched a variety of programs, including cash transfers, subsidies in-kind, public works, and income-generation programs. However, there is little guidance on appropriate program design, and few studies have synthesized the lessons from widely differing country experiences. This report fills that gap. It reviews the conceptual issues in the choice of programs, synthesizes cross-country experience, and analyzes how country- and region-specific constraints can explain why different approaches are successful in different countries.
America's Health Care Safety Net explains how competition and cost issues in today's health care marketplace are posing major challenges to continued access to care for America's poor and uninsured. At a time when policymakers and providers are urgently seeking guidance, the committee recommends concrete strategies for maintaining the viability of the safety netâ€"with innovative approaches to building public attention, developing better tools for tracking the problem, and designing effective interventions. This book examines the health care safety net from the perspectives of key providers and the populations they serve, including: Components of the safety netâ€"public hospitals, community clinics, local health departments, and federal and state programs. Mounting pressures on the systemâ€"rising numbers of uninsured patients, decline in Medicaid eligibility due to welfare reform, increasing health care access barriers for minority and immigrant populations, and more. Specific consequences for providers and their patients from the competitive, managed care environmentâ€"detailing the evolution and impact of Medicaid managed care. Key issues highlighted in four populationsâ€"children with special needs, people with serious mental illness, people with HIV/AIDS, and the homeless.
The State of Social Safety Nets 2018 Report examines global trends in the social safety net/social assistance coverage, spending, and program performance based on the World Bank Atlas of Social Protection Indicators of Resilience and Equity (ASPIRE) updated database. The report documents the main social safety net programs that exist globally and their use to alleviate poverty and to build shared prosperity. The 2018 report expands on the 2015 edition, both in administrative and household survey data coverage. A distinct mark of this report is that, for the first time, it tells the story of what happens with SSN/SA programs spending and coverage over time, when the data allow us to do so. This 2018 edition also features two special themes †“ Social Assistance and Ageing, focusing on the role of old-age social pensions, and Adaptive Social Protection, focusing on what makes SSN systems/programs adaptive to various shocks.
A sobering account of a disenfranchised American working class and important policy solutions to the nation’s economic inequalities One of the country’s leading scholars on economics and social policy, Isabel Sawhill addresses the enormous divisions in American society—economic, cultural, and political—and what might be done to bridge them. Widening inequality and the loss of jobs to trade and technology has left a significant portion of the American workforce disenfranchised and skeptical of governments and corporations alike. And yet both have a role to play in improving the country for all. Sawhill argues for a policy agenda based on mainstream values, such as family, education, and work. While many have lost faith in government programs designed to help them, there are still trusted institutions on both the local and federal level that can deliver better job opportunities and higher wages to those who have been left behind. At the same time, the private sector needs to reexamine how it trains and rewards employees. This book provides a clear-headed and middle-way path to a better-functioning society in which personal responsibility is honored and inclusive capitalism and more broadly shared growth are once more the norm.
This is an edited volume reviewing the major means-tested social programs in the United States. Each author addresses a major program or area, reviewing each area’s successes and recommending how to address shortcomings through policy change. In general, our means-tested programs do many things well, but some adjustments to each could make the system much more effective. This book provides policymakers with a broad overview of the issues at hand in each program and how to address them.
Including education has profound consequences, undergirding the case for the productivity of welfare state programs and the explanation for why all rich nations have large welfare states, and identifying US welfare state leadership. From 1968 through 2006, the United States swung right politically and lost its lead in education and opportunity, failed to adopt universal health insurance and experienced the most rapid explosion of health care costs and economic inequality in the rich world. The American welfare state faces large challenges. Restoring its historical lead in education is the most important but requires investing large sums in education, beginning with universal pre-school and in complementary programs that aid children's development.
Officially over in 2009, the Great Recession is now generally acknowledged to be the most devastating global economic crisis since the Great Depression. As a result of the crisis, the United States lost more than 7.5 million jobs, and the unemployment rate doubled—peaking at more than 10 percent. The collapse of the housing market and subsequent equity market fluctuations delivered a one-two punch that destroyed trillions of dollars in personal wealth and made many Americans far less financially secure. Still reeling from these early shocks, the U.S. economy will undoubtedly take years to recover. Less clear, however, are the social effects of such economic hardship on a U.S. population accustomed to long periods of prosperity. How are Americans responding to these hard times? The Great Recession is the first authoritative assessment of how the aftershocks of the recession are affecting individuals and families, jobs, earnings and poverty, political and social attitudes, lifestyle and consumption practices, and charitable giving. Focused on individual-level effects rather than institutional causes, The Great Recession turns to leading experts to examine whether the economic aftermath caused by the recession is transforming how Americans live their lives, what they believe in, and the institutions they rely on. Contributors Michael Hout, Asaf Levanon, and Erin Cumberworth show how job loss during the recession—the worst since the 1980s—hit less-educated workers, men, immigrants, and factory and construction workers the hardest. Millions of lost industrial jobs are likely never to be recovered and where new jobs are appearing, they tend to be either high-skill positions or low-wage employment—offering few opportunities for the middle-class. Edward Wolff, Lindsay Owens, and Esra Burak examine the effects of the recession on housing and wealth for the very poor and the very rich. They find that while the richest Americans experienced the greatest absolute wealth loss, their resources enabled them to weather the crisis better than the young families, African Americans, and the middle class, who experienced the most disproportionate loss—including mortgage delinquencies, home foreclosures, and personal bankruptcies. Lane Kenworthy and Lindsay Owens ask whether this recession is producing enduring shifts in public opinion akin to those that followed the Great Depression. Surprisingly, they find no evidence of recession-induced attitude changes toward corporations, the government, perceptions of social justice, or policies aimed at aiding the poor. Similarly, Philip Morgan, Erin Cumberworth, and Christopher Wimer find no major recession effects on marriage, divorce, or cohabitation rates. They do find a decline in fertility rates, as well as increasing numbers of adult children returning home to the family nest—evidence that suggests deep pessimism about recovery. This protracted slump—marked by steep unemployment, profound destruction of wealth, and sluggish consumer activity—will likely continue for years to come, and more pronounced effects may surface down the road. The contributors note that, to date, this crisis has not yet generated broad shifts in lifestyle and attitudes. But by clarifying how the recession’s early impacts have—and have not—influenced our current economic and social landscape, The Great Recession establishes an important benchmark against which to measure future change.
In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.