The earliest context in which madness is treated as an excuse for crime is Justinian's Digest. The Christian church brought this feature of Roman law to pre-Norman England. Madmen were probably not regarded as triable by ordeal, but were simply left to be guarded by their kinsfolk. When trial by ordeal was abandoned, and juries had to determine guilt, juries were at first expected to find madmen guilty but refer their cases to the king for pardon. It was not until about 1500 that juries seem to have begun to acquit on grounds of insanity. The reasoning varied: madmen were "punished enough by their madness"; they "lacked the will to harm"; they could not "tell good from evil." How strictly the tests of insanity were applied depended on the crime. The rejections of the defense that figured in the State Trials series were not typical, but gave historians the impression that the defense hardly ever succeeded before Hadfield's trial in 1800. In fact, as the Old Bailey Sessions Papers show, it often succeeded in the eighteenth century. Nor was this the result of empire building by the medical professions. Laymen's evidence was often accepted without any testimony by mad-doctors.
For defendants in the nineteenth century seeking refuge from the death penalty, the insanity defense was like a haven eagerly sought but with difficulty secured. For defendants now, no longer at risk of the death penalty and able to take advantage of statutory defenses akin to insanity, the defense has become like a reef fearfully avoided but easily struck. The transformation of the defense from shelter to snare is best understood when traced through the attempts of defendants to establish a defense of irresistible impulse due to mental disorder. At first, irresistible impulse was pleaded as insanity under the McNaughtan Rules. When this was no longer possible, defendants turned to the defense of involuntary conduct, a defense elaborated largely in response to the development of motoring. The courts' response to this tactic has breathed new life into the McNaughtan Rules, but legislation is required to remove resulting anomalies.
Man has always been concerned with and has devised strategic attitudes toward death. Since 1960 there has been a burgeoning of interest, as evidenced by the increase in writings about death, and a distinct shift in conceptualization. The literature is surveyed indicating the loci of increased interest, exploring the concerns of different groups—physicians, family members, clergymen, historians—and discussing the effects of modern life such as the impact of advanced medical technology.
The major policies and practices with regard to the civil and criminal commitment of the mentally ill in the Scandinavian countries during the 1970s and 1980s are described and discussed. Deinstitutionalization, community work, and outpatient treatment within geographically defined sectors have been introduced in all the Nordic countries. At the same time, criminally committed mental patients constitute an increasing proportion of the involuntarily hospitalized population. The special defense of insanity and tests such as McNaughtan are not used in the Scandinavian countries. The handling and disposition of severely mentally ill criminal defendants is closer to the notions of guilty but mentally ill in some U.S. jurisdictions, although in Scandinavia such persons are hospitalized and do not receive penal sentences. Even though forensic psychiatry has come under much criticism, there is still a need for psychiatric evaluations for courts and there is still a need for the provision of mental health treatment, rehabilitation, and follow-up for mentally disordered offenders.
This article reports on a sample of 538 African American and Hispanic women who were receiving TANF in 1999, 416 of whom left the program by 2005. The Hispanic women consisted of a Mexican-origin group and a second group that was primarily Puerto Rican and Dominican. Combining the experiences of the employed and the non-employed welfare leavers, we find at best a modest decline in the average poverty rate among African American welfare leavers between 1999 and 2005. Mexican-origin and other Hispanic leavers showed larger average declines in poverty. Among just the welfare leavers who were employed in 2005, the averages for women in all racial-ethnic groups showed increases in household income and declines in poverty. Among those who were not employed, African-Americans had experienced a decline in household income and were further below the poverty line than in 1999, whereas Hispanic women had experienced modest declines or slight increases in their household incomes.
By guaranteeing college admission to all students who graduate in the top 10% of their high school class, H.B. 588 replaced an opaque de facto practice of admitting nearly all top 10% graduates with a transparent de jure policy that required public institutions to admit all applicants eligible for the guarantee. The transparency of the new admission regime sent a clear message to students attending high schools that previously sent few students to the University of Texas at Austin and Texas A&M University. Using 18 years of administrative data to examine sending patterns, we find a sizeable decrease in the concentration of flagship enrollees originating from select feeder schools and growing shares of enrollees originating from high schools located in rural areas, small towns, and midsize cities, as well as schools with concentrations of poor and minority students. We also find substantial year-to-year persistence in sending behavior once a campus becomes a sending school, and this persistence increased after the top-10% policy was implemented.
This paper uses 10 years of enrollment data at four Texas public universities to examine whether, to what extent, and in what ways high school attended contributes to racial and ethnic differences in college achievement. Like previous studies, we show that controlling for observable pre-college achievement variables (e.g. test scores, class rank) shrinks, but does not eliminate, sizable racial differences in college achievement. Fixed-effects models that take into account differences across high schools that minority and nonminority youth attend largely eliminate, and often reverse, black-white and Hispanic-white gaps in several measures of college achievement. Our results, which are quite robust across universities of varying selectivity, illustrate how high school quality foments race and ethnic inequality in postsecondary achievement. Leveling inequities in the quality of high schools that minority students attend is a long-run agenda, but remediation programs that compensate for instructional shortfalls at low performing high schools may help close achievement gaps in the interim.
We use PISA 2009 data to determine how immigrant children in Italy and Spain compare with native students in reading and mathematics skills. Drawing on the vast empirical literature in traditional immigration countries, we test the extent to which the most well-established patterns and hypotheses of immigrant/native educational achievement gaps also apply to these new immigration countries. Findings show that both first- and second-generation immigrant students underperform natives in both countries. Although socioeconomic background and language skills contribute to the explanation of achievement gaps, significant differences remain within countries. While modeling socioeconomic background reduces the observed gaps to a very similar extent in the two countries, language spoken at home is more strongly associated with achievement in Italy. School-type differentiation, such as tracking in Italy and school ownership in Spain, do not reduce immigrant/native gaps, although in Italy tracking is strongly associated with students' test scores.
The insanity defense is a particularly controversial aspect of the interaction between law and mental health. During the past decade, many states have revised or abolished their insanity defenses. Oregon, however, chose in 1974 to retain its existing defense and create a new, unique system for the post-adjudication management of insanity acquitees. Oregon's legislature established the Psychiatric Security Review Board (PSRB), which is composed of five part-time members drawn from different disciplines, to conduct periodic hearings to determine the placement and supervision of defendants who successfully raise the insanity defense and remain mentally ill and dangerous. The PSRB has received national attention as a promising approach to managing mentally ill offenders. The authors first describe the structure and operation of the Oregon system. Then they summarize the empirical studies they have conducted of the PSRB in action.
Quantitative researchers distinguish between causal and effect indicators. What are the analytic problems when both types of measures are present in a quantitative reasoned action analysis? To answer this question, we use data from a longitudinal study to estimate the association between two constructs central to reasoned action theory: behavioral beliefs and attitudes toward the behavior. The belief items are causal indicators that define a latent variable index while the attitude items are effect indicators that reflect the operation of a latent variable scale. We identify the issues when effect and causal indicators are present in a single analysis and conclude that both types of indicators can be incorporated in the analysis of data based on the reasoned action approach.
Beginning in 1987, Peru imposed a regime of structural adjustment to transform its economy along neoliberal lines. This analysis suggests that a shift resulted in the odds of international migration and the motivations for leaving among inhabitants of Peru's largest labor market. Before 1987, under the regime of import substitution industrialization, jobs at wages capable of sustaining a basic standard of living were widely available; those few who left the country self-selected for higher human capital and moved abroad to improve their earnings. Under neoliberalism, however, both employment and wages fell to levels that made it difficult for families to sustain themselves. In response, households-with the assistance of friends and relatives with foreign experience-diversified their labor portfolios away from the local job market structural adjustment zones. The number of migrants then rose, the diversity of foreign destinations increased, and migration became less selective with respect to human capital.
The authors analyze the effects of structural adjustment and violence on international migration from selected countries in Latin America by estimating a series of event history models that predicted the likelihood of initial migration to the United States as a function of the murder rate, economic openness, and selected controls in the country of origin. Although several theories posit a connection between structural economic change and violence, such a pattern held only in Nicaragua, where the homicide rate increased as the economy was opened to trade and average incomes deteriorated. Moreover, only in Nicaragua was lethal violence positively related to out-migration. In Mexico, Costa Rica, and Guatemala, rising violence reduced the likelihood of emigration. Violence does not appear to have uniform effects on patterns of international migration but depends on broader social and political conditions within particular countries.
Human service programs have gone from a period of rapid growth in the 1960s and early 1970s to a period of retrenchment in the 1980s. The changing political and economic context has forced these programs to undergo major organizational transformations and to adopt different administrative strategies. These include degovernmentalization of social services, reliance on cutback management, and deprofessionalization of human-service workers. The article explores the implications of these developments on the delivery of services to the public.
This paper uses administrative data for the two most selective Texas public institutions to examine the application, admission and enrollment consequences of rescinding affirmative action and implementing the top 10% admission regime. We simulate the gains and losses associated with each policy regime and also those from assigning minorities the application, admission and enrollment rates for white students. Challenging popular claims that the top 10% law restored diversification of Texas's public flagships, our analyses that consider both changes in the size of high school graduation cohorts and institutional carrying capacity show that the uniform admission regime did not restore Hispanic and black representation at UT and TAMU even after four years. Simulations of gains and losses at each stage of the college pipeline across admission regimes for Hispanics and blacks confirm that affirmative action is the most efficient policy to diversify college campuses, even in highly segregated states like Texas.
Immigrants' age at arrival matters for schooling outcomes in a way that is predicted by child development theory: the chances of being a high school dropout increase significantly each year for children who arrive in a host country after the age of eight. The authors document this process for immigrants in the United States from a number of regions relative to appropriate comparison regions. Using instrumental variables, the authors find that the variation in education outcomes associated with variation in age at arrival influences adult outcomes that are important in the American mainstream, notably English-language proficiency and intermarriage. The authors conclude that children experience migration differently from adults depending on the timing of migration and show that migration during the early years of child development influences educational outcomes. The authors also find that variation in education outcomes induced by the interaction of migration and age at arrival changes the capacity of children to become fully integrated into the American mainstream as adults.
This article uses data from the 1979 and 1997 cohorts of the National Longitudinal Survey of Youth to estimate the proportions of young men and women who will take on a variety of partner and parent roles by age 30, as well as to describe how these estimates have changed across cohorts. It then draws from identity theory and related theoretical work to consider how the multiple family roles which young adults are likely to occupy-both over their life course and at a single point in time-may influence inter- and intra-family (unit) relationships in light of current trends in family complexity. This discussion highlights four key implications of identity theory as it relates to family complexity, and proposes several hypotheses for future empirical research to explore, such as the greater likelihood of role conflict in families with greater complexity and limited resources. Implications for public policy are also discussed.
The implications of recent immigration for race relations in the United States depend importantly on family cultural orientations among Mexican Americans and how this group is culturally perceived by Anglos. Because Moynihan's 1965 work (in)famously emphasized the need to change black family culture in order to ameliorate black poverty, his work still holds implications for understanding how cultural orientations affect changing color lines. Unfortunately, his partially insightful analyses inadequately foresaw that policies designed to alleviate poverty through the modification of family cultural patterns are likely to fail without parallel changes in structural opportunities. Similar limitations also often emerge from mis-characterizations of Mexican origin family cultural situations, which all too often are incongruously reified as either being unduly familistic (thus falsely implying Mexican origin families foster self-sufficiency) or largely governed by culture of poverty tendencies (thus inaccurately suggesting Mexican origin families depend on welfare). Here we review research suggesting that Mexican origin families are neither substantially familistic nor disproportionately susceptible to moral hazard, thus indicating that future Mexican origin economic advancement is likely to turn on the availability of structural opportunities. In-depth interviews with Anglos further suggest that Mexicans are not culturally viewed with the same degree of prejudice and discrimination as blacks, implying that the integration of Mexicans into American society, contingent on adequate economic opportunity, will probably progress more steadily than often feared, while that of blacks may proceed more slowly than often expected.
The Tarasoff decisions of the California Supreme Court in 1974 and 1976 held that psychotherapists could be held liable for failing to protect the victims of their potentially violent patients. Our survey of psychiatrists, psychologists, and social workers in eight metropolitan areas showed that Californians were more likely to have heard of the case, to believe it required warning the likely victim, and actually to issue warnings in such cases than were psychotherapists from other jurisdictions. Thera pists were more willing to take steps to protect victims in 1980 than in 1975, but willingness to warn increased more among Californians than among those in other states. We conclude that although Tarasoff has influenced therapists' attitudes and behavior more in California than elsewhere, the case has also affected psychotherapeutic practice nationally.
The Medicare and Medicaid programs, which were enacted through the 1965 amendments to the Social Security Act, placed the federal government in the central role of assuring access of the aged and the poor to needed medical care. In this article the trends in the sources of financing medical care services for the aged are examined. The distinction in terms of insurance coverage between acute care services and long-term care services is highlighted. The effect of the programs in terms of reducing the aged's direct financial cost of medical care, increasing their access to medical services, and improving their health status is explored. The unanticipated increase in the cost of these programs has led to a change in emphasis in public policy, from assuring access to mainstream medical care to containing the cost of providing care. The direction of new federal policies is analyzed, and it is concluded that no longer will it follow the private sector's specifications of the conditions and arrangements under which health services are provided to program beneficiaries.
The demographic revolution—engendered in large part by modern medicine—which has led to the extraordinary and continuing increase in the number and proportion of elderly persons in the population has profound implications for health services. The elderly are dispropor tionately heavy utilizers of health care, primarily because of the prevalence of chronic disease. In the United States most health care for the elderly is financed through public funds, and costs have been increasing at an alarming rate. There is wide consensus that, for all the excellence of performance of the medical care system in treating acute episodes, care of chronic disease is frequently unsatisfactory in both quality and cost. Given the demographic imperatives, reform of mechanisms for chronic care is thus essential.
The twentieth century has been a time of great economic and social stress during which people have experienced war, economic depression, and the failure of philosophical sustenance. Technological discoveries, which have prolonged life, have also presented older people with problems of adjustment for which they are ill prepared. Only their remarkable capacities for adaptation, relearning, and renewal have armed them to withstand the onslaught of diminishing physiological, cultural, and social attacks.
The acquired immune deficiency syndrome (AIDS) is a harbinger for change in health care. There are many powerful forces poised to transform the industrialized health care structure of the twentieth century, and AIDS may act as either a catalyst or an amplifier for these forces. AIDS could, for example, swamp local resources and thereby help trigger national reform in a health care system that has already lost public confidence. AIDS can also hasten the paradigm shift that is occurring throughout health care. Many of the choices society will confront when dealing with AIDS carry implications beyond health care. Information about who has the disease, for example, already pits traditional individual rights against group interests. Future information systems could make discrimination based upon medical records a nightmare for a growing number of individuals. Yet these systems also offer the hope of accelerated progress against not only AIDS but other major health threats as well. The policy choices that will define society's response to AIDS can best be made in the context of a clearly articulated vision of a society that reflects our deepest values.
Before the end of 1988, 300,000 cases of acquired immune deficiency syndrome (AIDS) are expected to have been reported worldwide since 1981. Three epidemiological patterns have emerged. One, in the Americas and Europe, is where transmission is primarily among homosexual men and intravenous drug users. In Africa, the virus primarily is spread heterosexually. A third pattern, in Asia, the Middle East, and Eastern Europe, is manifested by low prevalence but transmission through homosexual and heterosexual contact and contaminated needles. AIDS cases will increase in number dramatically over the next three years, with devastating social and economic consequences. Health-care systems and economic resources in large cities in the United States will be severely strained. African countries will lose many educated and economic leaders. Many Third World countries will have lower productivity and economic output. A global strategy is emerging to understand and control the spread of AIDS. To provide the commitment and leadership necessary to control AIDS in the rest of the world, the United States must first demonstrate a stronger moral conviction and societal will to control the disease in this country.
Health care expenditures now account for nearly 10 percent of our gross national product, the highest share ever recorded. Concerned that this represents too many resources being devoted to health care, policymakers are searching for ways to control health care expenses. These include higher coinsurance and deductibles, measures to increase market shares of health maintenance organizations, and conversion from cost reimbursement to prospective reimbursement. These measures contain many incentives for patients and providers to alter use of health care services. However, aggregate resource use may or may not be lower and more efficient under these new programs. To determine whether limited resources would be devoted to maximizing the nation's health, incentives inherent in each policy option must be examined. This article describes a classification of types of disease and medical care outputs. The framework is then used to examine incentives offered to patients and providers by three alternative payment mechanisms—capitation, fee-for-service, and payment by diagnosis—regarding types of disease treated and mix of outputs produced. This type of analysis is required to select an appropriate payment mechanism for obtaining a socially acceptable allocation of resources.
Developments in modern medical technology force many questions upon the health professions and the public. To what extent should technology be used to extend life when doing so seems futile, perhaps brutal? Who should decide such questions? What options should be available? Conditions in which such questions arise are often chaotic because of the nature of illness and treatment and because many extremely important issues in life have been poorly deliberated by the health professions and the public. This essay is an attempt to clarify some of the issues.
Not all biases are equivalent, and not all biases are uniformly negative. Two fundamental dimensions differentiate stereotyped groups in cultures across the globe: status predicts perceived competence, and cooperation predicts perceived warmth. Crossing the competence and warmth dimensions, two combinations produce ambivalent prejudices: pitied groups (often traditional women or older people) appear warm but incompetent, and envied groups (often nontraditional women or outsider entrepreneurs) appear competent but cold. Case studies in ambivalent sexism, heterosexism, racism, anti-immigrant biases, ageism, and classism illustrate both the dynamics and the management of these complex but knowable prejudices.
Available data have consistently pointed up the failure of U.S. policies to reduce undocumented migration from Latin America. To shed light on the reasons for this failure, we estimated a series of dynamic models of undocumented entry into and exit from the United States. Our estimates suggest that undocumented migration is grounded more in mechanisms posited by social capital theory and the new economics of labor migration rather than neoclassical economics. As a result, U.S. efforts to increase the costs of undocumented entry and reduce the benefits of undocumented labor have proven unsuccessful given the widespread access of Latin Americans to migrant networks. The main effect of U.S. enforcement efforts has been to reduce the circularity of Latin American migration.
This analysis draws on longitudinal, qualitative interviews with disadvantaged mothers and fathers who participated in the Fragile Families Study (a U.S. birth cohort study) to examine how issues related to men's employment, social support, skills, and motivation facilitated their care of young children in different relationship contexts. Interviews with parents indicate that while some motivated and skilled men actively chose to become caregivers with the support of mothers, others developed new motivations, skills, and parenting supports in response to situations in which they were out of work or the mother was experiencing challenges. These findings suggest that disadvantaged men who assume caregiving responsibilities take different paths to involvement in the early years after their child's birth. Policies that overlook paternal caregivers may not only miss the opportunity to support relationships that benefit at-risk children but also unintentionally undermine this involvement.
Market reforms began in parts of Asia after World War II and led to macroeconomic policies and governance that brought rapid and fairly evenly shared growth, with an emphasis on promoting capable civil services, community involvement, and good basic education and health. For historical and cultural reasons, reforms began decades later in most of Latin America. To bypass ossified bureaucracies, operating under largely democratic governments with elements of civil societies, Latin American reforms were under strongmen, or caudillos, who undertook macroeconomic reforms due to conviction or expediency or both. The leaders used teams of technocrats who operated alongside and above preexisting bureaucracies. Reforms began first and went furthest in Chile. After case studies of Chile, Argentina, Peru, Mexico, and Venezuela, the author concludes that Latin American reforms will not really serve their people or be secure until, like the Asian reforms, they stress competent and honest governance, shared growth, and basic education and health.
This volume arose from a 2002 request for proposals issued by the Andrew W. Mellon Foundation on “Urban Studies and Demography.” In response to that request, we submitted a proposal to undertake a program of training and research on “Social Responses to Structural Adjustment in Latin American Cities.” Douglas S. Massey and Jere Behrman served as co–principal investigators on the project, supported by Magaly Sanchez R. as a postdoctoral research associate. The grant was made to the University of Pennsylvania, where Massey and Behrman were on the faculty, and it supported work carried out during academic years 2002–2003 and 2003–2004.
In addition to a small grants program to support pilot research conducted by faculty and students affiliated with the Population Studies Center and the Urban Studies Program at Penn, during the first year of the award Massey, Sanchez, and Behrman collaborated in organizing a weekly seminar series that brought in specialists from throughout North and South American to make presentations on the consequences of structural adjustment within different countries. The papers presented offered such a coherent chain of evidence that yielded such clear and consistent conclusions that we decided to gather them together in a volume that would illustrate what happens when a massive social experiment is launched in a major world region without a firm understanding of the complexities involved.
The resulting volume is literally beyond the capacity of any one of us to produce, as it draws upon knowledge, expertise, and experience that is far too varied to be contained in a single human being. The chapters draw upon substantive and theoretical knowledge from the disciplines of sociology, economics, demography, anthropology, and urban studies and cover numerous countries in Latin America. The final product reveals how the idea for structural adjustment arose, the means by which it was applied to diverse countries throughout the region, the negative consequences it had within major economies, and the lessons learned from that experience.
We are grateful to the Andrew W. Mellon Foundation for its financial support and to Carolyn Makinson, its program officer for population, for her encouragement and advice. But we are also mindful of the situation of the subjects of our study. The 1980s are commonly called la dedaca perdida (“the lost decade”) by Latin Americans, and after a promising start early in 1990s the subsequent decade fared little better. Regionwide GDP fell in absolute terms during the 1980s and increased by an anemic 2 percent during the 1990s. Bearing in mind the widespread material suffering these figures imply, the editors would like also to dedicate this volume to the millions of people throughout Latin America and the Caribbean who had their world turned upside down by the economic turmoil of the late twentieth century. It is they who ultimately contributed the most to this volume, sacrificing much of their prior progress and material well-being to prove a point.
We present a method for dividing the historical development of community migration streams into an initial period and a subsequent takeoff stage with the purpose of systemically differentiating pioneer migrants from follower migrants. The analysis is organized around five basic research questions. First, can we empirically identify a juncture in the historical development of community-based migration that marks the transition from an initial stage of low levels of migration and gradual growth into a takeoff stage in which the prevalence of migration grows at a more accelerated rate? Second, does this juncture point exist at roughly similar migration prevalence levels across communities? Third, are first-time migrants in the initial stage (pioneers) different from first-time migrants in the takeoff stage (followers)? Fourth, what is the nature of this migrant selectivity? Finally, does the nature and degree of pioneer selectivity vary across country migration streams?
In this paper, I compare the transition into legal permanent residence (LPR) of Mexicans, Dominicans, and Nicaraguans. Dominicans had the highest likelihood of obtaining residence, mostly sponsored by parents and spouses. Mexicans had the lowest LPR transition rates and presented sharp gender differentials in modes: women mostly legalized through husbands while men were sponsored through IRCA, parents. Nicaraguans stood in-between, presenting few gender differences in rates and modes of transition and a heavy dependence on asylum and special provisions such as IRCA and NACARA. I argue these patterns stem from the interplay of conditions favoring the emigration of and the specific immigration policy context faced by migrant pioneers; the influence of social networks in reproducing the legal character of flows; and differences in the actual use of kinship ties as sponsors. I discuss the implications of these trends on the observed gendered patterns of migration from Latin America.
The American Indian population has continued to increase at a rate greater than other identifiable populations in the United States. The 1970 census returns indicate that 45 percent of the Indian population resides in urban areas. Indians have moved to urban centers and urban life has moved to Indians since many communities are surrounded by urban and surburban sprawl. The total Indian population has experienced cultural and language loss. At the same time more Indians are being educated up to and beyond the college level. Young Indians with institutional experience, whether in schools or prisons, are becoming either militant or bureau cratic. We infer that the turmoil which has characterized American Indian life since 1950 is a function of Indians' deter mination to maintain their identity and values in the face of overwhelming pressures to change. The future will feature more of the same unless Indians feel free to make their own adjustment.
This article discusses recent trends in fertility, marriage, and divorce in the period since 1965 in the United States. It describes briefly the sharp changes in patterns of births, marriage, informal unions, divorce, and remarriage. Very recent developments of note include the increasingly important place of cohabitation in the life course, the continuing postponement of marriage, and the rise in birth rates to women in their thirties. Explanations are examined that emphasize both the increased economic opportunities for women and the cultural shift toward a greater emphasis on individualism and self-fulfillment. In the concluding section, it is argued that concerns about fertility and the family in the years ahead will focus less on the number of children than on whether their upbringing and education will be adequate to meet the needs of a society with a relatively small labor force and a large dependent population.
Although migration from Mexico to the United States is more than a century old, until recently most other countries in Latin America did not send out significant numbers of migrants to foreign destinations. Over the past thirty years, however, emigration has emerged as an important demographic force throughout the region. This article outlines trends in the volume and composition of the migrant outflows emanating from various countries in Latin America, highlighting their diversity with respect to country of destination; multiplicity of destinations; legal auspices of entry; gender and class composition; racial, ethnic, and national origins; and the mode of insertion into the receiving society. The review underscores the broadening of international migration away from unidirectional flows toward the United States to new streams going to Europe, Canada, Australia, and Japan, as well as to other countries in Latin America itself.
The provision of health and medical care to American Indians and Alaska Natives has undergone major changes in the 150 years during which the federal govern ment has assumed responsibility for these services. Signifi cant legislation leading to present programs and directions is reviewed to place current programs in the perspective of historic evolution. The changing patterns of disease indicate that Indian health status is rapidly approaching that of the Western world, with a reduction in infectious diseases and an increase in psychosocial problems and chronic conditions. In order to provide quality health care under isolated, rural conditions, the Indian Health Service is exploring innovative uses of paraprofessionals and the application of modern space technology to primary care settings.
Guided by social disorganization theory, this article examines the influence of neighborhood characteristics on intragroup and intergroup robbery, net of spatial proximity in a predominantly native-born Latino/Mexican-origin city-San Antonio, Texas. From census tract and official police robbery data, the findings indicate that intragroup robbery is more common than intergroup robbery. Multivariate results show that variation in black intra-group robbery lies primarily in highly disadvantaged neighborhoods; whereas variation in Latino intergroup robbery is found in neighborhoods with more disadvantage, racial/ethnic heterogeneity, recent immigrants, and blacks. Residential instability persistently influences all robbery types. Disaggregating robberies by race and ethnicity reveals the importance of examining Latinos as offenders and victims. The case of San Antonio serves as a harbinger of conditions that may exist in the growing number of majority-Latino cities-and suggests the need to investigate crime experiences that move beyond studying racial dichotomies of violence.
The 1970s was a decade of particularly rapid change in life styles in the US. The postponement of marriage by many young adults and the escalating divorce rates resulted in a large increase in the population of one person households. Sharp increases in the proportion of illegitimate births--in combination with rising rates of separation and divorce--brought substantial increases in the proportion of children living in one-parent families. Average household size and average family size declined. The total fertility rate, which had declined by 50% from 1960 to 1975, leveled off after 1975. 1st and 2nd births to women 25-34 years old increased significantly after 1975, suggesting that these cohorts were making up for their very low levels of fertility in previous years. Illegitimate birthrates, which had almost quadrupled between 1940 and 1970, decreased during the 1970s; however, the proportion of all births that were illegitimate continued to increase. These changes are not interpreted as evidence that Americans are moving away from their basic orientation to marriage and a family existence.
Decisions of the United States Supreme Court in 1963 and 1972 expanded the scope of the free exercise clause of the First Amendment beyond any previous inter pretation of that clause in American judicial history. Although it is still understood that government may prohibit religiously motivated behavior which represents harm to individuals or to the public welfare, civil authorities now may intervene only when the religious activity threatens a compelling state interest. The possibilities of religious activity are abundant, and government intervention is limited to only the gravest offenses of the public order. This article examines some of the areas of health, broadly defined, in which religious attitudes have conflicted with state interests: the handling of poisonous snakes and drinking of poison in religious worship, the use of prohibited drugs in worship, compulsory blood transfusions for those who have theological objections to them, and the application of public health laws to those whose theology rejects medicine altogether. In the light of these cases, as much as the American constitutional system exalts religious liberty, it can never be unfettered. But, even in this area, it is imperative that our governmental units make religious liberty the rule and its curtailment the exception.
This article argues in favor of a new image of pre-Hispanic politics in Mesoamerica by positing the existence of an Aztec states-society during the fifteenth and early sixteenth centuries. This society was based on a series of common assumptions, interests, and institutions that fostered a close degree of cooperation between member states.
In this article, the authors report the results of a large-scale field experiment conducted in New York City investigating the effects of race and a prison record on employment. Teams of black and white men were matched and sent to apply for low-wage jobs throughout the city, presenting equivalent resumés and differing only in their race and criminal background. The authors find a significant negative effect of a criminal record on employment outcomes that appears substantially larger for African Americans. The sequence of interactions preceding hiring decisions suggests that black applicants are less often invited to interview, thereby providing fewer opportunities to establish rapport with the employer. Furthermore, employers' general reluctance to discuss the criminal record of an applicant appears especially harmful for black ex-offenders. Overall, these results point to the importance of rapport-building for finding work, something that the stigmatizing characteristics of minority and criminal status make more difficult to achieve.
Much of the debate over the underlying causes of discrimination centers on the rationality of employer decision making. Economic models of statistical discrimination emphasize the cognitive utility of group estimates as a means of dealing with the problems of uncertainty. Sociological and social-psychological models, by contrast, question the accuracy of group-level attributions. Although mean differences may exist between groups on productivity-related characteristics, these differences are often inflated in their application, leading to much larger differences in individual evaluations than would be warranted by actual group-level trait distributions. In this study, the authors examine the nature of employer attitudes about black and white workers and the extent to which these views are calibrated against their direct experiences with workers from each group. They use data from fifty-five in-depth interviews with hiring managers to explore employers' group-level attributions and their direct observations to develop a model of attitude formation and employer learning.
Nativity differences in birth outcomes in the United States are well documented, with more favorable outcomes among children of foreign-born parents than those of native-born parents. Using longitudinal data on mothers from the United States Fragile Families and Child Wellbeing Study (N ~ 4,000) and the United Kingdom Millennium Cohort Study (N ~ 15,000), the authors provide a comparative and longitudinal perspective on nativity differences in mothers’ health behaviors. First, the authors ask whether healthier behaviors observed among Hispanic immigrants in the United States extend to foreign-born mothers in the United Kingdom, including South Asian, black African and Caribbean, and East Asian immigrants. Second, the authors consider the persistence of differences throughout early childhood. The findings demonstrate healthier behaviors among foreign-born mothers in both the United States and the United Kingdom, including both socioeconomically disadvantaged and advantaged mothers. These differences are stable over early childhood, suggesting a “universality” of healthier behaviors among foreign-born mothers, spanning racial/ethnic and socioeconomic groups, time, and two different policy contexts.
In 1971 the government of the People's Republic of China launched the third birth control campaign. The goals were to raise the age at marriage, lengthen the birth interval, and limit the number of births per family to two in the cities and three in the countryside. A birth-quota and pregnancy-authorization system was instituted. The campaign was greatly facilitated by the nationwide network of free community-based contraceptive and abortion services and generous incentives. By the early 1980s the contraceptive prevalence rate rose to 70 percent, and the total fertility rate fell to about 2.5 children per woman of reproductive age. The year 1979 saw the introduction of the one-child campaign. By 1982 first births accounted for 47 percent of total births, and 42 percent of the one-child families had pledged to have no more children. The successful implementation of the one-child campaign will, however, lead to a rapid aging of the population. The percentage of the population older than 64 years of age will increase rapidly, from 5 percent in 1982 to 7.3-7.7 percent in 2000 and to 23-27 percent in 2050. With such a high aged-dependency ratio, caring for the aged will entail heavy fiscal outlay in the twenty-first century.
Recent legal changes in Washington State have broadened the grave-disability criterion for civil commitment of the mentally ill. Analysis of data from state mental hospitals and from records of commitment authorities in Washington's two largest counties revealed that, while there was an increase in the number of involuntary hospitalizations immediately before and after the changes in law, there was a virtual disappearance of voluntary patients in state hospitals. Moreover, expansion of the definition of "grave disability" resulted in a move toward a parens patriae-dominated civil commitment system. Analysis of the empirical consequences of the legal changes on commitment decisions is presented, along with the response of mental health officials and the public.
In the 1980s the convergence of a number of factors is causing government at all levels, industry, and labor to plan or initiate major reductions in health spending. Important among these are rising health care costs, a troubled national economy, mounting federal deficits and state revenue shortfalls, and the philosophical course and domestic policy of the Reagan administration. In this context government has been rethinking its capacity to finance health services for the poor, and new and sometimes controversial arrangements for delivering these services are being developed. The dilemma government officials face now is how to cut costs while still assuring that quality medical services are available. This article focuses on what these new policy developments and arrangements are and whether the significant gains in access and in health achieved over the past 20 years will be sustained. Because truly sweeping reforms are unlikely, whether government will maintain earlier commitments and established arrangements for financing and delivering health services to the poor will be worked out piecemeal over the next several years.
Western values have long emphasized an interventionist approach to problems of health and health care. Yet, as medical technology becomes increasingly expensive and as the number of older people grows, proposed changes often are now governed more by considerations of cost than by quality of services. This tension between cost and quality also affects public willingness to invest in social components of health care despite their importance in enhancing quality of life. The tension emerges in sharpest contrast as scarce resources are allocated by gatekeepers in health maintenance organizations and in the arrangements for long-term care. With respect to financing, what seems to be needed is a creative mix of voluntary inputs from the community, private initiatives, and new programs of public entitlements. With respect to quality of care, what has often been overlooked is the recognition that gains in the quality of life require programs that encourage older people's continued involvement and participation in social life and in active and healthy life-styles. This article discusses the evolving balance between these two types of interventions: the medical and the social.
Most economic relationships are either arm's-length exchange transactions, each party seeking his or her own interest, or command structures, such as a firm or public agency, integrating joint efforts toward a common goal. The health care industry, however, displays a pattern of incomplete vertical integration--relationships which are neither truly arm's-length nor completely hierarchical. The doctor-patient relationship is archetypical. Physicians appear to sell services in private markets; yet they reach through the exchange process to direct the consumer-patient's utilization decisions, implicity undertaking to act in the patient's interest, and thus integrate forward. But they also integrate backward to control the public regulatory process--self-government--and some forms of insurance. The health care systems of different countries--Canada, the United Kingdom, and the United States--can be interpreted as different patterns of incomplete integration among five basic classes of transactors: consumer-patients, first-line providers, second-line providers, insurers, and governments. Each system of linkage has characteristic strengths and weaknesses. Nowhere, however, do we find a predominance of arm's-length market relationships. Where they exist, markets in health care are usually pseudomarkets dominated by one side of the transaction. The rhetoric of market relationships serves principally to obscure political struggles over shifting patterns of integration.