Search

More young adults in the United States are studying beyond high school and working full-time than in the past, yet young adults continue to have high poverty rates as they transition to adulthood. This study uses longitudinal data on two cohorts of young adults from the 1979 and 1997 National Longitudinal Study of Youth to assess whether conventional benchmarks associated with economic success-gaining an education, finding stable employment, and delaying childbirth until after marriage-are as predictive of reduced poverty today as they were in the past. We also explore differences in the protective effect of the benchmarks by race/ethnicity, gender, and poverty status while young. We find that, on average, the benchmarks associated with economic success are as predictive of reduced poverty among young adults today as they were for the prior generation; however, demographics and features of the economy have contributed to higher poverty rates among today's young adults., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Temporary workers' health problems in China have raised concerns recently. This study aimed to assess the relationship between temporary employment and three health outcomes with gradient severity and explore mediating mechanisms. Data was obtained from a national cross-sectional survey (China General Social Survey 2018). Compared with regular workers, temporary workers reported more frequent mood disorders (β = 0.197) and disturbance of daily activities (β = 0.132), however, there was no significant difference in serious health risks (inpatient treatment) between temporary and regular workers. Income poverty, subjective social status, and family relative socioeconomic status were significant mediators. The results suggest that temporary workers have higher general health risks, and economic deprivation is the main mechanism. Therefore, Chinese policymakers should provide more inclusive preventive health services beyond the existing health care system focused on critical illness to reduce the general health risks of grassroots workers., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Area-based deprivation indices are used in many countries to target interventions and policies to populations with the greatest needs. Analyses of the Carstairs deprivation index applied to postcode sectors in 2001 identified that less than half of all deprived individuals lived in the most deprived areas., Objective: This article examines the specificity and sensitivity of deprivation indices across Great Britain in identifying individuals claiming income- and employment-related social security benefits., Study Design: This was a descriptive analysis of cross-sectional administrative data., Methods: The data sets for the 2020 Scottish Index of Multiple Deprivation, Scottish Income and Employment Index, the 2019 English Index of Multiple Deprivation and the 2019 Welsh Index of Multiple Deprivation were obtained. For each data set, small areas were ranked by increasing overall deprivation, and the cumulative proportions of individuals who were income and employment deprived were calculated. Receiver operating characteristic curves were plotted to show the sensitivity and specificity of each index, and the percentages of income- and employment-deprived individuals captured at different overall deprivation thresholds were calculated., Results: Across all indices, the sensitivity and specificity for detecting income- and employment-deprived individuals were low, with less than half living in the most deprived 20% of areas. Between 55% and 62% of income-deprived people and between 56% and 63% of employment-deprived people were missed across the indices at the 20% deprivation threshold. The sensitivity and specificity were slightly higher for income deprivation than employment deprivation across indices and slightly higher for the Scottish Index of Multiple Deprivation and Scottish Income and Employment Index than for the English Index of Multiple Deprivation and Welsh Index of Multiple Deprivation., Conclusion: Area-based deprivation measures in Great Britain have limited sensitivity and specificity for identifying individuals who are income or employment deprived. Place-based policies and interventions are unlikely to be effective at reducing inequalities as a result. Creation of individually linked data sets and interventions that recognise the social and economic relationships between social groups are likely to be more effective., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Cumulative exposure to childhood adversity is associated with a variety of labour market outcomes in young adulthood. It remains largely unclear whether the type of adversity matters in this association. This prospective study examined the differences in exposure to 14 adverse experiences among groups of young adults aged 22 characterised by distinct labour market participation states and employment conditions., Methods: We used data from the TRacking Adolescents' Individual Lives Survey, a Dutch prospective cohort study with 15 years of follow-up (N=1524). We included 14 adverse experiences (ages 0-16) across five domains: peer influences, loss or threat of loss, material deprivation, family dynamics and maltreatment. Labour market participation states and employment conditions were assessed at age 22. We used latent class analysis to derive labour market outcome groups, which we subsequently compared on exposure to adverse experiences using pairwise comparisons., Results: Inactive individuals (n=85, 5.6%), often neither in education (77.4%) nor employment (98.6%) and on benefits (94.4%), were more likely to be exposed to many distinct types of adverse experiences (eg, parental addiction, bullying victimisation) as compared with all other groups. Early workers (n=413, 27.1%), often on temporary contracts and low monthly incomes, were more likely to be exposed to parental divorce (22.7%) compared with students with side jobs (12.9%)., Conclusions: Different adverse experiences are not equally associated with labour market outcomes. Researchers and stakeholders in policy and practice should be aware of the differences between adverse experiences in their importance for labour market outcomes in young adults., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)

Poverty is a big threat to prosperity in developing countries like Pakistan. Alleviating poverty needs concerted efforts including how to measure and analyze poverty. Therefore, this paper employs synthetic panel technique and uses repeated cross-sections household survey dataset (Household Integrated and Economic Survey (HIES)) of Pakistan for 2010-11 and 2015-16, to derive poverty bounds for Pakistan. The findings of the paper suggest that 17% of population still remains in poverty in 2015-16 as they were in 2010-11. They don't move in or out of poverty. In the same periods 19% population affected by poverty. The 2.5% poor's of 2010-11 moves out of poverty in 2015-16. This constitutes the first attempt to provide an insight into poverty dynamics in Pakistan using the available survey data., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Shabnam et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Poverty continues to burden millions of Canadians each year, and social assistance (SA) is one program that provides last-resort financial assistance, conditional upon looking for and accepting work. Using tax panel data of SA recipients from across seven Canadian regions between 2000 and 2018, we model the probabilities of employment success (ES) across industry of employment, SA benefit amounts, unionization, and individual-level characteristics. We adopt an economic stance to explain reliance upon SA, examining the broader macroeconomic indicators of ES, and to demonstrate the factors associated with exiting SA. We find that many SA recipients do not present evidence of recent employment, indicating a disconnect between stated SA program aims and their outcomes. We provide evidence for increased SA benefits and unionization as significant predictors of ES of SA recipients., (© 2023 Canadian Sociological Association/La Société canadienne de sociologie.)

The pandemic and the current situation have caused working poverty and therefore social risk, which implies a deterioration in well-being, affecting mental health and anxiety. In this context, the employment situation tends to be regarded ignoring previous social differences, economic and mental components, which should be considered when establishing priorities to program a global action of various synergistic elements. The study involved 4686 people (3500 women and 1186 men). They all completed a questionnaire that evaluated their anxiety, employment situation, income, changes of working status, and fears of becoming infected at the workplace. The results show the need to take into account the social determinants of mental health in vulnerable groups due to socioeconomic factors, job changes, contractual changes, age, or gender, considering the need to generate strategies to manage mental health and deal with it at a structural level, therefore displacing individual focus policies and interventions. An example of these policies are ERTEs (record of temporary employment regulation), constituting a perceived measure of protection and acting as an effective buffer against the economic crisis, thus reducing anxiety.

The federal Senior Community Service Employment Program (SCSEP) provides on-the-job training to people 55 years and older with incomes at or below 125% of the federal poverty level with multiple barriers to employment. This study examined the processes by which SCSEP may influence participant financial, physical, and mental well-being. We engaged 15 SCSEP participants and case managers over four virtual and one telephone session using a participatory research method called community-based system dynamics. Activities included identifying key problem trends, variable elicitation, developing a causal map, and identifying changes to the system to increase participant well-being. Respondents identified how individual, organizational, and program and policy factors relate to participant well-being (e.g., SCSEP participation reduces social isolation, which increases desire to participate) and suggested program and policy recommendations to strengthen SCSEP (e.g., benchmarks of success should include health and well-being outcomes). These findings highlight the benefits and potential of this long-running program.

Objectives: We explore the effects of non-contributory pensions on functional limitations and receipt of unpaid family care by gender and frequency of pension payment. Methods: We employ a difference-in-differences estimator to identify the causal effects of non-contributory pension programs disbursed monthly or every two months for adults 70 years and older in the state of Yucatan, Mexico. Results: The monthly payment program led to lower difficulties in functional limitations and less receipt of help from family or relatives for older men and women as compared to the bimonthly program. We found a larger decline on receipt of family care for older women than for men. Discussion: Our results suggest that more frequent pension payments may have greater health benefits for recipients. They also highlight the need for greater understanding of policies that prevent or delay functional limitations and that could indirectly alleviate unpaid caregiver burden.

Background: While employment programs were not created with the intent to improve common mental disorders (CMDs), they may have a positive impact on the prevalence, incidence, and severity of CMD by reducing poverty and increasing access to economic mobility., Aim: To examine and synthesize the available quantitative evidence of the impact of employment programs on outcomes of CMD., Methods: Embase, Econlit, Global Health, MEDLINE, APA PsychINFO, and Social Policy and Practice were searched for experimental and quasi-experimental studies which investigated the impact of employment programs on primary and secondary outcomes of a CMD. A narrative synthesis according to Popay was conducted. The methodological quality of studies was assessed with the Cochrane Risk of Bias tool and the Newcastle-Ottawa Assessment Scale., Results: Of the 1,327 studies retrieved, two randomized controlled trials, one retrospective cohort, one pilot study with a non-randomized experimental design, and one randomized field experiment were included in the final review. Employment programs generally included multiple components such as skills-based training, and hands-on placements. Depression and anxiety were the CMDs measured as primary or secondary outcomes within included studies. Findings regarding the impact of employment programs on CMD were mixed with two studies reporting significantly positive effects, two reporting no effects, and one reporting mixed effects. The quality among included studies was good overall with some concerns regarding internal validity., Conclusion: Employment programs may support a decrease in the prevalence, incidence, and severity of CMDs. However, there is high heterogeneity among study effects, designs, and contexts. More research is needed to gain further insight into the nature of this association and the mechanisms of impact. This review highlights the potential for employment programs and other poverty-reduction interventions to be utilized and integrated into the wider care, prevention, and treatment of common-mental disorders.

Research has established that certain forms of underemployment relate to poorer mental health, but no studies have examined which components of underemployment are uniquely related to mental health over time. To address this gap in the literature, we longitudinally examined how multiple subjective underemployment constructs (i.e., underpayment, status, involuntary temporary work, field, poverty-wage employment, involuntary part-time work, and overqualification) predicted symptoms of distress in a large sample of working adults in four waves over 9 months. We also identified group differences in underemployment. Results revealed that involuntary part-time work, involuntary temporary work, and poverty-wage employment fluctuated with distress over the course of the study, but only involuntary temporary work predicted greater symptoms of distress over time. Group differences also revealed that gender, age, level of education, and subjective social class predicted various forms of subjective underemployment. Findings encourage researchers, practitioners, and policymakers to consider involuntary temporary work as potentially harmful to mental health and inform the future examination of mental health inequities for marginalized groups. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Background: Medicaid community engagement requirements previously received federal approval in 12 states, despite limited data on their impact on enrollees' employment-related activities. Our objective was to assess longitudinal changes in enrollees' employment and student status after implementation of Michigan's Medicaid expansion., Methods: Longitudinal telephone survey of Michigan Medicaid expansion enrollees in 2016 (response rate [RR] = 53.7%), 2017 (RR = 83.4%), and 2018 (N = 2,608, RR = 89.4%) serially assessing self-reported employment or student status. Survey responses were benchmarked against statewide changes in assessed similar low-income adults in the U.S. Census Bureau Current Population Survey. We used mixed models with individual random effects to assess changes in the proportion of enrollees who were employed or students by year., Results: Most respondents had incomes < 100% FPL (61.7% with 0-35% of the federal poverty level [FPL], 22.9% with 36-99% FPL, and 15.4% with 100-133% FPL), 89.3% had at least a high school diploma/equivalent, and they ranged in age (39.6% age 19-34, 34.5% age 35-50, 25.9% age 51-64). Employment or student status increased significantly among Michigan Medicaid expansion respondents, from 54.5% in 2016 to 61.4% in 2018 (P < 0.001), including among those with a chronic condition (47.8% to 53.8%, P < 0.001) or mental health/substance use disorder (48.5% to 56.0%, P < 0.001). In contrast, the statewide proportion of low-income non-elderly adults who were employed or students did not change significantly (from 42.7% in 2016 to 46.0% in 2018, P = 0.57)., Conclusions: Medicaid expansion, absent a community engagement requirement, was associated with increased employment and related activities. The role of Medicaid in providing safety-net coverage to individuals during times of economic stress is likely to grow., (© 2022. The Author(s).)

Background: The major determinants of health and well-being include wider socio-economic and political responses to poverty alleviation. To data, however, South Korea has no related social protection policies to replace income loss or prevent non-preferable health conditions for workers. In particular, there are several differences in social protection policies by gender or occupational groups. This study aimed to investigate how hospitalization affects income loss among workers in South Korea., Methods: The study sample included 4876 Korean workers who responded to the Korean Welfare Panel Study (KoWePS) for all eight years from 2009 to 2016. We conducted a receiver operating characteristics (ROC) analysis to determine the cut-off point for the length of hospitalization that corresponded to the greatest loss of income. We used panel multi-linear regression to examine the relationship between hospitalization and income loss by gender and employment arrangement., Results: The greatest income loss for women in non-standard employment and self-employed men was observed when the length of hospitalization was seven days or less. When they were hospitalized for more than 14 days, income loss also occurred among men in non-standard employment. In addition, when workers were hospitalized for more than 14 days, the impact of the loss of income was felt into the subsequent year., Conclusion: Non-standard and self-employed workers, and even female standard workers, are typically excluded from public insurance coverage in South Korea, and social security is insufficient when they are injured. To protect workers from the vicious circle of the poverty-health trap, national social protections such as sickness benefits are needed., (© 2022. The Author(s).)

Research on in-work poverty has focused on the probability of being employed while living in an impoverished household, but no studies have investigated pathways of labor market attachment and economic vulnerability following in-work poverty. We use the Panel Study of Income Dynamics (PSID) to establish a typology of employment pathways out of in-work poverty and to estimate differences by gender and race. By using the Sequence Analysis Multistate Model procedure, we identify five distinct pathways characterized by varying degrees of labor market attachment, economic vulnerability, and volatility. White men are most likely exit in-work poverty into stable employment outside of poverty, while Black men and women often experience recurrent spells of in-work poverty. Gender and race differences persist even after controlling for labor market and family demographic characteristics. Our results indicate that work-related anti-poverty strategies must be coupled with adequately high wages and employment protection legislation to effectively raise working households out of poverty., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Governments, employers, and trade unions are increasingly developing "menopause at work" policies for female staff. Many of the world's most marginalised women work, however, in more informal or insecure jobs, beyond the scope of such employment protections. This narrative review focuses upon the health impact of such casual work upon menopausal women, and specifically upon the menopausal symptoms they experience. Casual work, even in less-then-ideal conditions, is not inherently detrimental to the wellbeing of menopausal women; for many, work helps manage the social and emotional challenges of the menopause transition. Whereas women in higher status work tend to regard vasomotor symptoms as their main physical symptom, women in casual work report musculoskeletal pain as more problematic. Menopausal women in casual work describe high levels of anxiety, though tend to attribute this not to their work as much as their broader life stresses of lifelong poverty and ill-health, increasing caring responsibilities, and the intersectionally gendered ageism of the social gaze. Health and wellbeing at menopause is determined less by current working conditions than by the early life experiences (adverse childhood experiences, poor educational opportunities) predisposing women to poverty and casual work in adulthood. Approaches to supporting menopausal women in casual work must therefore also address the lifelong structural and systemic inequalities such women will have faced. In the era of COVID-19, with its devastating economic, social and health effects upon women and vulnerable groups, menopausal women in casual work are likely to face increased marginalisation and stress. Further research is need., Competing Interests: Conflicts of interest The authors declare no conflict of interest.

This paper represents one of the most recent and pertinent studies conducted in Afghanistan, aiming to address the societal imperative of comprehending the factors behind the fall of the Republic government and the subsequent rise of the Taliban to power. Furthermore, the paper seeks to analyse public attitudes towards the current situation. Employing a quantitative approach, the research utilizes a descriptive-analytical method through questionnaires and the participants include social media activist, students and universities professors, the data collected by online survey according WhatsApp, Facebook messengers, telegram, email and other social media groups from different ethnic groups. The findings of this research have identified several pivotal factors contributing to the ascent of the Taliban to power, including the US-Taliban agreement in Doha, Qatar; political disparities; administrative and financial corruption within the Republic's administration; Pakistan's support for the Taliban; the previous government's accord with the Taliban; ethnic dominance; robust military morale of the Taliban; and proficient war management by the Taliban. Afghanistan, as a multi-ethnic society, witnesses political dynamics predominantly rooted in ethnic affiliations. The majority of respondents express dissatisfaction with the current Afghan situation, displaying significant concerns for the populace. Foremost concerns, in terms of prioritization, encompass poverty; closure of girls' schools; restrictions on women's education and employment; escalation of civil unrest; mono-ethnic rule; ethnic conflicts; emergence of ISIS; ethnic marginalization; violations of citizenship rights; political participation and legitimacy crises; and authoritarianism. Consequently, to address the political crisis and establish a viable system, the research concludes that while Pashtuns lean toward a centralized system, Hazaras, Tajiks, Uzbeks, and Turkmens evince greater interest in a decentralized structure.

Cash assistance allocations from Temporary Assistance for Needy Families (TANF) and its predecessor program fell from $34.3 billion to $7.4 billion in real value from 1993 to 2016, a 78% decrease. Some investigations of TANF point to favorable labor market changes as the source of the decline, whereas others point to declining benefit levels and barriers to benefit receipt. This study introduces a framework to decompose the decline of TANF cash assistance into changes in need for cash assistance, the participation rate among those meeting income-based eligibility standards, and benefit levels among those receiving cash support. Using the U.S. Current Population Survey, I find that declining participation explains 52% of the decline in TANF cash assistance from 1993 onward, whereas declining need explains 21%, and declining benefit levels explain 27%. The study then applies reweighting techniques to measure the extent to which compositional changes in the population, such as rising employment rates among single mothers, can explain changes in need, participation, and benefit levels. The results suggest that compositional changes explain only 22% of the decline of TANF cash assistance, confirming that the majority of the decline is due to reduced participation and benefit levels rather than reduced demand for cash support. Adding the noncompositional share of the decline in TANF back to observed levels of cash spending in 2016 would result in nearly $20 billion in additional transfers, more than the minimum amount necessary to lift all single-mother households out of poverty., (Copyright © 2021 The Author.)

This paper investigates economic impacts of COVID-19 on households based on differences in the socio-economic status (SES). We determine the household-level effects of the COVID-19 shock using income sources, types of industries, communities' resilience, household susceptibility, and relevant policy measures. For this purpose, we used primary data of 555 households collected through snowball sampling technique using an online survey questionnaire from different villages mostly located in Sichuan Province, China. Using step-wise binary logistic regression analysis, we estimated and validated the model. Results suggest the use of SES as a better measure for understanding the impacts of COVID-19 on different households. We find that households with low SES tend to depend more on farmland income and transfer payments from the government. Contrarily, high SES households focus more on business and local employment as sources of income generation. Poor households were less resilient and more likely to fall back into poverty due to COVID-19, while the opposite stands true for non-poor households with high SES. Based on the estimations, policies encouraging employment and businesses complemented with loans on lower interest rates are recommended, which may increase the SES, thus minimizing vulnerability and enhancing the households' resilience towards poverty alleviation and economic shocks., Competing Interests: The authors have declared that no competing interests exist.

The COVID-19 pandemic disrupted food systems and the economy in the U.S. and abroad. This cross-sectional study examined the direct and indirect impacts of COVID-19 on food access among low-income and Black, Indigenous, and people of color (BIPOC) in New York State. New York residents were recruited to complete a web-based survey through Qualtrics. The survey took place in May and June 2020 and asked participants about COVID-19 health impacts, risk factors, and food access. Chi-square analysis examined issues with food access experienced by demographic characteristics, work disruptions, health impacts, and household risk for contracting the virus and experiencing severe illness, and significant results were analyzed in a series of logistic regression models. After accounting for covariates, Hispanic respondents, those with likely Major Depressive Disorder, and essential workers were more likely to experience worse food access during COVID-19. Improved policies and services to address impacts on vulnerable populations such as BIPOC, those suffering from mental health disorders, and workers in lower-paying essential jobs can reduce the risk of food access issues at this time. Future research can identify how food access issues during the pandemic influenced diet quality, chronic disease risk and infection, and persistence of food access issues.

The study is to investigate psychological self-sufficiency-the force within someone that activates cognitive and non-cognitive process of shifting perceived barriers into hope actions-as it relates to economic self-sufficiency among jobseekers with mental health barriers. Among a sample of 2455 low-income jobseekers in job readiness programs at six community-based agencies in Chicago, a subsample of 424 who self-identified as having mental illness barriers are selected to analyze the relationships between employment hope, employment barriers, and economic self-sufficiency using structural equation modeling. Results indicate that employment hope mediates the path between perceived employment barriers and economic self-sufficiency. The study further highlights the positive effects of employment barriers on employment hope among jobseekers with perceived mental illnesses. The findings support growing evidence that psychological self-sufficiency is positively associated with gaining economic self-sufficiency in workforce development programs.

Context: Twenty states are pursuing community engagement requirements ("work requirements") in Medicaid, though legal challenges are ongoing. While most nondisabled low-income individuals work, it is less clear how many engage in the required number of hours of qualifying community engagement activities and what heterogeneity may exist by race/ethnicity, age, and gender. The authors' objective was to estimate current levels of employment and other community engagement activities among potential Medicaid beneficiaries., Methods: The authors analyzed the US Census Bureau's national time-use survey data for the years 2015 through 2018. Their main sample consisted of nondisabled adults between 19 and 64 years with family incomes less than 138% of the federal poverty level (N = 2,551)., Findings: Nationally, low-income adults who might become subject to Medicaid work requirements already spent an average of 30 hours per week on community engagement activities. However, 22% of the low-income population-particularly women, older adults, and those with less education-would not currently satisfy a 20-hour-per-week requirement., Conclusions: Although the majority of potential Medicaid beneficiaries already meet community engagement requirements or are exempt, 22% would not currently satisfy a 20-hour-per-week requirement and therefore could be at risk for losing coverage., (Copyright © 2020 by Duke University Press.)

Job skills training is a cost-effective strategy for improving employment among individuals who have low income and employment barriers, but few U.S. government-sponsored employment program participants have received such training. To better understand long-term gains from job skills training, this study compared employment and earnings trajectories between program participants who received job skills training and those who received basic services only. Using data from the National Longitudinal Survey of Youth 1979, we estimated 33-year employment and earnings trajectories among U.S. baby-boomer cohorts while accounting for baseline group heterogeneity using inverse propensity score weighting. We found increases in employment rates over the life course, especially among Black women. Job skills training also increased earnings by up to 69.6 % compared to basic services only. Despite the long-term gains in employment and earnings, job skills training participation is not sufficient to address gender as well as racial and ethnic gaps in full-time employment. Findings reinforce the importance of incorporating job skills training as an essential service element of government-sponsored employment programs to improve long-term labor market outcomes among Americans with economic disadvantages., (Copyright © 2020. Published by Elsevier Ltd.)

Background: Childhood disruptive behaviors are highly prevalent and associated with adverse long-term social and economic outcomes. Trajectories of welfare receipt in early adulthood and the association of childhood behaviors with high welfare receipt trajectories have not been examined., Methods: Boys (n = 1000) from low socioeconomic backgrounds were assessed by kindergarten teachers for inattention, hyperactivity, aggression, opposition, and prosociality, and prospectively followed up for 30 years. We used group-base trajectory modeling to estimate trajectories of welfare receipt from age 19-36 years using government tax return records, then examined the association between teacher-rated behaviors and trajectory group membership using mixed effects multinomial regression models., Results: Three trajectories of welfare receipt were identified: low (70.8%), declining (19.9%), and chronic (9.3%). The mean annual personal employment earnings (US$) for the three groups at age 35/36 years was $36 500 (s.d. = $24 000), $15 600 (s.d. = $16 275), and $1700 (s.d. = $4800), respectively. Relative to the low welfare receipt group, a unit increase in inattention (mean = 2.64; s.d. = 2.32, range = 0-8) at age 6 was associated with an increased risk of being in the chronic group (relative risk ratio; RRR = 1.16, 95% CI 1.03-1.31) and in the declining group (RRR = 1.13, 95% CI 1.03-1.23), after adjustment for child IQ and family adversity, and independent of other behaviors. Family adversity was more strongly associated with trajectories of welfare receipt than any behavior., Conclusions: Boys from disadvantaged backgrounds exhibiting high inattention in kindergarten are at elevated risk of chronic welfare receipt during adulthood. Screening and support for inattentive behaviors beginning in kindergarten could have long-term social and economic benefits for individuals and society.

In June 2018 Arkansas became the first US state to implement work requirements in Medicaid, requiring adults ages 30-49 to work twenty hours a week, participate in "community engagement" activities, or qualify for an exemption to maintain coverage. By April 2019, when a federal judge put the policy on hold, 18,000 adults had already lost coverage. We analyze the policy's effects before and after these events, using a telephone survey performed in late 2019 of 2,706 low-income adults in Arkansas and three control states compared with data from 2016 and 2018. We have four main findings. First, most of the Medicaid coverage losses in 2018 were reversed in 2019 after the court order. Second, work requirements did not increase employment over eighteen months of follow-up. Third, people in Arkansas ages 30-49 who had lost Medicaid in the prior year experienced adverse consequences: 50 percent reported serious problems paying off medical debt, 56 percent delayed care because of cost, and 64 percent delayed taking medications because of cost. These rates were significantly higher than among Arkansans who remained in Medicaid all year. Finally, awareness of the work requirements remained poor, with more than 70 percent of Arkansans unsure whether the policy was in effect.

It has long been the goal of many gerontological social work scholars to increase the ability and opportunity for people to be engaged in paid and unpaid work throughout the life course. Yet the COVID-19 pandemic is revealing and exacerbating the financial insecurity of many older adults. In this paper, we review information related to older workers and how they might be affected by this pandemic and its aftermath, paying particular attention to the most socioeconomically and physically vulnerable older workers. We also offer first-hand experiences from our careers working with and conducting scholarship on older workers, paying particular attention to recent actions by many in the Senior Community Service Employment Program (SCSEP) network to provide paid sick leave to its low-income, older adult participants. We conclude with implications for social work scholarship and teaching, noting the uptick in technology use among older adults and the disparities that remain, as well as teaching that integrates discussions on the lifelong and cumulative effects of inequalities and marginalization and the need for additional researcher, student, and community collaborations.

Much of the focus on human rights and mental health in low- and middle-income countries (LMICs) has been on protection from coercion and abuse and on expanding access to mental health services, rather than on promoting and protecting social and economic rights. Despite the importance of work for mental health, there has been very limited consideration of the relationship between work and mental health in LMICs. This paper draws on ethnographic and participatory research in urban and rural sites in Ghana to illustrate the meanings and value of work, as well as experiences of support, exclusion, and discrimination, among people with lived experience of mental illness in Ghana. The paper outlines the policy context of mental health and human rights in Ghana and evaluates the challenges of implementing mental health, disability, and labor legislation to protect the rights of persons with mental illness-particularly the poorest and most vulnerable-in both formal and informal employment. The paper closes by discussing the potential of practices of solidarity and social activism to promote the rights of people with mental illness and push for change., Competing Interests: Competing interests: None declared., (Copyright © 2020 Read, Sakyi, and Abbey.)

Importance: Increased work requirements have been proposed throughout federal safety net programs, including the Supplemental Nutrition Assistance Program (SNAP). Participation in SNAP is associated with reduced food insecurity and improved health., Objectives: To determine whether SNAP work requirements are associated with lower rates of program participation and to examine whether there are racial/ethnic disparities or spillover effects for people with disabilities, who are not intended to be affected by work requirements., Design, Setting, and Participants: This nationally representative, pooled cross-sectional study examined how changes in SNAP work requirements at state and local levels in the US are associated with changes in food voucher program participation. The study combined information on state and local SNAP work requirements with repeated cross-sections from the 2012 through 2017 American Community Survey (with outcomes covering 2013 to 2017). The analytical approaches were based on difference-in-difference and triple-difference methods, after controlling for other economic and social factors. The sample included low-income adults without dependents, stratified by racial/ethnic group and disability status. The study also included parents who would otherwise meet work requirement criteria as a comparison group to estimate triple-difference models. This accounted for otherwise unobserved factors affecting trends in SNAP participation within local areas. Data were analyzed from January 2019 through March 2020., Exposure: Residence in areas where SNAP work requirements apply., Main Outcomes and Measures: The primary outcome is SNAP participation measured by whether anyone in the household received food vouchers at any point over the prior 12 months., Results: The final analytical sample included 866 000 low-income adults (weighted mean [SE] age, 33.6 [0.01] years; 42.5% [SE, 0.07%] men). The racial/ethnic breakdown was 56.5% (SE, 0.07%) non-Hispanic white respondents, 19.4% (SE, 0.06%) non-Hispanic black respondents, 17.7% (SE, 0.06%) Hispanic respondents, 2.5% (SE, 0.02%) Asian respondents, and 3.9% (SE, 0.03%) respondents of other or multiple races. In final triple-difference models, work requirements were associated with a 4.0 percentage point decrease in participation (95% CI, -0.048 to -0.032; P < .001) for childless adults without disability, equivalent to a 21.2% reduction in SNAP participation (95% CI, -25.5% to -17.0%). For childless adults with disability, work requirements were associated with a 4.0 percentage point reduction (95% CI, -0.058 to -0.023; P < .001), equivalent to 7.8% fewer SNAP participants with disability (95% CI, -11.2% to -4.4%). When the final models were stratified by race/ethnicity, benefit reductions were larger for non-Hispanic black adults (7.2 percentage points; 95% CI, -0.092 to -0.051; P < .001) and Hispanic adults (5.5 percentage points; 95% CI, -0.072 to -0.038; P < .001) than for non-Hispanic white adults (2.6 percentage points; 95% CI, -0.035 to -0.016; P < .001)., Conclusions and Relevance: Because of the association of SNAP with food security and health, work requirements that lead to benefit loss may create nutritional and health harm for low-income Americans. These findings suggest that there may be racially disparate consequences and unintended harm for those with disability.

Objectives. To examine spillover effects of job skills training (vs basic services only [e.g., adult basic education, job readiness training]) on substance misuse among low-income youths with employment barriers. Methods. Data came from the National Longitudinal Survey of Youth 1997, a longitudinal cohort study of youths born between 1980 and 1984 in the United States. Based on respondents' reports of substance misuse (past-month binge drinking and past-year marijuana and other illicit drug use) from 2000 to 2016, we estimated substance misuse trajectories of job skills training (n = 317) and basic services (n = 264) groups. We accounted for potential selection bias by using inverse probability of treatment weighting. Results. Compared with the basic services group, the job skills training group showed notable long-term reductions in its illicit drug misuse trajectory, translating to a 56.9% decrease in prevalence rates from 6.5% in year 0 to 2.8% in year 16. Conclusions. Job skills training can be an important service component for reducing substance misuse and improving employment outcomes among youths with economic disadvantages and employment barriers.

Background: Poverty, unemployment and substance abuse are inter-related problems. This study evaluated the effectiveness of abstinence-contingent wage supplements in promoting drug abstinence and employment in unemployed adults in outpatient treatment for opioid use disorder., Methods: A randomised controlled trial was conducted in Baltimore, MD, from 2014 to 2019. After a 3-month abstinence initiation and training period, participants (n=91) were randomly assigned to a usual care control group that received employment services or to an abstinence-contingent wage supplement group that received employment services plus abstinence-contingent wage supplements. All participants were invited to work with an employment specialist to seek employment in a community job for 12 months. Abstinence-contingent wage supplement participants could earn training stipends for working with the employment specialist and wage supplements for working in a community job, but had to provide opiate and cocaine-negative urine samples to maximise pay., Results: Abstinence-contingent wage supplement participants provided significantly more opiate and cocaine-negative urine samples than usual care control participants (65% vs 45%; OR=2.29, 95% CI 1.22 to 4.30, p=0.01) during the 12-month intervention. Abstinence-contingent wage supplement participants were significantly more likely to have obtained employment (59% vs 28%; OR=3.88, 95% CI 1.60 to 9.41, p=0.004) and lived out of poverty (61% vs 30%; OR=3.77, 95% CI 1.57 to 9.04, p=0.004) by the end of the 12-month intervention than usual care control participants., Conclusion: Abstinence-contingent wage supplements can promote drug abstinence and employment., Trial Registration Number: ClinicalTrials.gov NCT02487745., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: Children with low self-control who grow up in poverty are at elevated risk for living in poverty when they are adults. The purpose of this study was to further understanding of the intergenerational continuity of poverty by (a) examining the likelihood that children with low levels of self-control at age 11 earn less employment income and are more likely to live in poverty 14 years later, at age 25; and (b) determining, via a preventive intervention, whether enhancing supportive parenting during childhood will ameliorate these associations., Methods: Parents and their 11-year-old children from 381 families participated in the Strong African American Families (SAAF) program or a control condition. Teachers assessed children's self-control at 11 years; parents reported their use of supportive parenting when children were 11 and 13 years; emerging adults provided data on cognitive and emotional self-control at 19, 20, and 21 years; and young adults indicated their employment income at 25 years., Results: Significant two-way interactions were detected between children's self-control and prevention condition for employment income (b = -183.18, 95% CI [-363.82, -2.53], p < .05) and poverty status (b = 0.257, 95% CI [0.018, 0.497], p < .05). Low self-control at age 11 forecast less employment income and a greater likelihood of living in poverty among children in the control condition, but not among low self-control SAAF participants. Mediated moderation analyses confirmed that enhanced supportive parenting accounted for SAAF's effects on employment income (indirect effect = 63.057, 95% BCA [19.385, 124.748]) and poverty status (indirect effect = -0.071, 95% BCA [-0.165, -0.016])., Conclusions: This study is unique in using a randomized controlled trial to show that preventive interventions designed to enhance parenting and strengthen families can buffer the long-term economic consequences of low self-control., (© 2019 Association for Child and Adolescent Mental Health.)

Objectives: Nurse-Family Partnership (NFP) is an evidence-based home visitation program designed for low-income, first-time mothers to support pregnancy, child development, and maternal self-sufficiency. This study examined educational and employment outcomes among NFP clients compared to a reference sample., Design: Entropy balancing and a difference-in-difference design were used to compare the two samples of women from 2007 to 2016., Sample: There were 127,427 women in the NFP sample, and 787 women in the reference cohort., Measurements: Educational outcomes included high school completion and employment outcomes consisted of employment status., Results: Across a one-year interval, NFP mothers with less than a high school diploma or general education diploma (GED) at baseline showed a 9.5 percentage point increase in diploma or GED attainment compared to the reference mothers [95% CI: 0.015-0.180]. Similarly, mothers enrolled in NFP who were not employed at baseline showed a 7.8 percentage point increase in employment compared to the reference mothers [95% CI: 0.003-0.150]., Conclusions: The findings in this study show positive results for NFP mothers attaining high school completion and employment compared to mothers in the reference group. Such findings are of importance with regard to progression toward economic self-sufficiency and corresponding reduction of health disparities., (© 2020 Wiley Periodicals, Inc.)

Integrative value generation through negotiated business deals is a fundamental way in which organizations and economic systems attain economic benefits. It is also an important way in which individuals can improve their financial situation. We propose that individuals most in need of improving their financial standing, those in a financially vulnerable situation, are least likely to reap the benefits of integrative value generation. We theorize that financial vulnerability induces a more zero-sum construal of success, or a view that success for one person must come at another person's success. A more zero-sum construal of success, in turn, hampers negotiators' ability to realize integrative potential in negotiations. In a large archival dataset ( N = 191,648), we found evidence that various proxies of financial vulnerability are associated with a more zero-sum construal of success. In two subsequent face-to-face negotiation studies, we found that financial vulnerability, whether measured or induced experimentally, undermined integrative value generation. The final two-part study found evidence of the hypothesized psychological process. Taken together, our studies uncover a fundamental pathway through which the disadvantage of financially vulnerable people is reproduced through economic exchanges. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Background: A recurring discussion in the literature relates to the possible contradictions among the Sustainable Development Goals (SDGs). The focus has been on economic goals, such as economic growth and goals related to climate change. We explore the possible contradictions that may arise between economic goals and health goals, specifically, the goal on Non-Communicable Diseases (NCDs) - SDG3.4. As a way to achieve SDG3.4, countries have been urged to introduce sin taxes, such as those on sugar. Yet others have argued that such taxes may affect employment (SDG 8.5), economic growth (SDG 8.1), and increase poverty (SDG1). However, there is limited or no reliable evidence, using actual experience, on the effect of sugar tax on health and economic outcomes. This makes it hard to assess the possible contradictions in SDGs that sugar taxes may generate., Main Body: Using a conceptual framework on SDGs that views relationships among SDGs as either contradictory, reinforcing, or neutral, we carefully consider whether there are contradictions between SDG 3.4 on one hand and SDG 1, SDG 8.1, and SDG 8.5 on the other hand. We illustrate this using Zambia which recently introduced an equivalent 3% tax on non-alcoholic beverages, implicitly targeted at sugar-sweetened beverages (SSBs), given the stated goal of reducing NCDs. Concerns are that such a tax would be detrimental to the Zambia sugar value chain which contributes about 6% to GDP, in which case the achievement of SDG 3.4 (health) would be at odds with, or contradict, SDG 1, SDG 8.1, and SDG 8.5 (poverty eradication, economic growth, and creation of employment). We discuss that the existence of contradictions depend on a number of contextual factors, which allows us to make two conclusions about sugar taxation in Zambia. First, the current tax rate of 3% is likely neutral (no contradictions or reinforcing relationships) because it is too low to have any health or employment effects. However, the revenue raised can be reinvested to improve livelihoods. Secondly, the tax rate should be increased but care has to be exercised to ensure that the rate is not too high to generate contradictions. There will be need to carefully assess important parameters such as elasticities and explore alternative economic livelihoods., Conclusion: Without paying due consideration to important contextual factors, Zambia and many LMIC risk experiencing contradictions among SDGs.

Background: Precarious employment has increased in Germany by means of labour market flexibilisation throughout the 1990s and 2000s. In this study, trends in the association of self-rated health (SRH) with different dimensions of precarious employment by gender in Germany between 1995 and 2015 were assessed considering different periods of labour market reforms and the Great Recession., Methods: Analyses were conducted using the German Socio-Economic Panel from 1995 to 2015. All employed individuals aged 18-67 years and living in private households were considered for analysis to examine the risks of poor SRH by low wage, working poverty, non-standard working time arrangements and perceived job insecurity by gender. Predicted probabilities, adjusted risk ratio (ARR), adjusted risk difference (ARD) and trends were examined using pooled interval logistic regression with individual-clustered standard errors., Results: Relative and absolute differences in SRH rose significantly over time by perceived job insecurity for men, but not for women. Working poverty appeared to be significantly associated with SRH in the Great Recession and the post-Recession period for both gender. Non-standard working time arrangements were not significantly associated with SRH for both gender, and low wage appeared to be significantly associated with SRH only for men in the post-Recession period., Conclusions: The results highlighted the relevance of labour market reforms of deregulation and flexibilisation in Germany to differences in SRH by specific forms of precarious employment and gender differences in the impact of labour market reforms on precarious employment and health., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

This article synthesizes the work-related dynamics that contribute to economic inequality and identifies ways for psychologists to offer their expertise to mitigate poverty through employment and re-employment. We summarize scholarship from subspecialties under the umbrella of work psychology to explore concepts germane to understanding unemployment, underemployment, and reemployment. The review and synthesis is organized around 4 primary themes that concern the relationships between work, economic inequality, and poverty. First, unemployment has devastating financial and psychological consequences for individuals, families, and communities. Second, reemployment is challenging to acquire but crucial to recovering from unemployment and escaping poverty. Third, systemic and societal factors, such as employment bias and gaps in employment law, shape and constrain employment processes for individuals and organizations. Fourth, the nature of employment is changing because of technological advances, growth in the contingent labor force, and globalized business relationships that introduce new concerns for underemployment, unemployment, and reemployment processes for individuals. We conclude by charting important directions for future research, describing promising interventions for practitioners, and summarizing opportunities for psychologists to apply their knowledge and expertise to support policies that can alleviate poverty. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Working families have increasingly enrolled their children in Medicaid or the Children's Health Insurance Program in recent years. Parents' place of employment affects the availability and cost of family health insurance, making it a determinant of pediatric public insurance enrollment. We examined that enrollment in the period 2008-16 in families working full time and earning more than 100 percent of the federal poverty level at three types of employers. Among low-income families (100-199 percent of poverty), children's public health insurance coverage was highest for those with parents employed at small private firms, increasing from 53 percent to 79 percent, while the public insurance coverage rate also increased among children with parents working for large private firms (from 45 percent to 69 percent). Among moderate-income families (200-299 percent of poverty) working at small private firms, public coverage increased from 21 percent to 64 percent. Increases in the number of working families with pediatric public insurance were driven by employees of large private firms. Maintaining high pediatric insurance coverage rates will require policies that recognize the changing role of public insurance for working families as the cost of employer-based coverage grows.

Background: There has been an overall decreasing trend in the inflow into disability pension in Switzerland since 2003 with the exception of young adults. Disablement in young adulthood reflects a particularly critical phenomenon given the potentially far-reaching long-term social, economic and health consequences. The aim of this study was therefore to identify factors for disability pension in young adults aged 18-39, living in Switzerland., Methods: We used the 2010-2015 cross-sections of the Social protection and labour market; a unique dataset linking microdata from the Swiss Labour Force Survey, the Swiss Central Compensation Office Register, and the Unemployment Insurance Register. Multiple logistic regression was employed to explore the association between demographic, socioeconomic, and health factors and disability pension in young adults living in Switzerland with long-term activity limitation (N = 5306). Alternative specifications of the benchmark model were estimated as robustness checks; and subsample analyses were conducted excluding (i) those aged 18-24 and (ii) those with partial disability pension., Results: Our regression results showed that those living without a working partner (OR 2.11; 95% CI 1.51-2.94) and without a child aged 0-14 (OR 2.15; 95% CI 1.48-3.12), born in Switzerland (OR 2.68; 95% CI 1.87-3.84), of higher age (OR 1.16; 95% CI 1.12-1.19), having completed at most lower secondary school (OR 3.26; 95% CI 2.24-4.76), lacking income throughout the four-year period prior to interview (OR 3.94; 95% CI 2.70-5.75), suffering from chronic illness (OR 4.52; 95% CI 2.83-7.19), and severe long-term activity limitation (OR 4.52; 95% CI 2.83-7.19) had higher odds of DP. Our findings were robust to alternative specifications and subsamples; and the alternative specifications revealed differences by learnt occupation, with highest odds for those without an occupational qualification (OR 5.93; 95% CI 3.72-9.46; p-value 0.000) and for those in 'Manufacturing' (OR 3.59; 95% CI 1.91-6.71) relative to 'Health, education, culture, and science'., Conclusions: Most importantly, our results showed that educational and employment factors are of high relevance, as well as chronic morbidity and severe long-term activity limitation. From a policy perspective, early intervention should thus focus on the attainment of vocational and academic qualifications beyond the lower secondary level, facilitating school-to-work transition and labour market integration.

Two-generation human capital programs for families provide education and workforce training for parents simultaneously with education for children. This study uses a quasi-experimental design to examine the effects of a model two-generation program, CareerAdvance, which recruits parents of children enrolled in Head Start into a health care workforce training program. After 1 year, CareerAdvance parents demonstrated higher rates of certification and employment in the health care sector than did matched-comparison parents whose children were also in Head Start. More important, there was no effect on parents' short-term levels of income or employment across all sectors. CareerAdvance parents also experienced psychological benefits, reporting higher levels of self-efficacy and optimism, in addition to stronger career identity compared with the matched-comparison group. Notably, even as CareerAdvance parents juggled the demands of school, family, and employment, they did not report higher levels of material hardship or stress compared with the matched-comparison group. These findings are discussed in terms of the implications of a family perspective for human capital programs. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Importance: Identifying early childhood behavioral problems associated with economic success/failure is essential for the development of targeted interventions that enhance economic prosperity through improved educational attainment and social integration., Objective: To test the association between kindergarten teacher-rated assessments of inattention, hyperactivity, opposition, aggression, and prosociality in boys with their employment earnings at age 35 to 36 years as measured by government tax return data., Design, Setting, and Participants: A 30-year prospective follow-up study analyzing low socioeconomic neighborhoods in Montreal, Quebec, Canada. Boys aged 5 to 6 years attending kindergarten in low socioeconomic neighborhoods were recruited. Teacher-rated behavioral assessments were obtained for 1040 boys. Data were collected from April 1984 to December 2015. Analysis began January 2017., Main Outcomes and Measures: Mixed-effects linear regression models were used to examine the association between teacher ratings of inattention, hyperactivity, opposition, aggression, and prosociality at age 6 years and individual earnings obtained from government tax returns at age 35 to 36 years. The IQ of the child and family adversity were adjusted for in the analysis., Results: Complete data were available for 920 study participants (mean age at follow-up was 36.3 years). Mean (SD) personal earnings at follow-up were $28 865.53 ($24 103.45) (range, $0-$142 267.84). A 1-unit increase in inattention (mean [SD], 2.66 [2.34]; range, 0-8) at age 6 years was associated with decrease in earnings at age 35 to 36 years of $1295.13 (95% CI, -$2051.65 to -$538.62), while a unit increase in prosociality (mean [SD], 8.0 [4.96]; range, 0-20) was associated with an increase in earnings of $406.15 (95% CI, $172.54-$639.77). Hyperactivity, opposition, and aggression were not significantly associated with earnings. Child IQ was associated with higher earnings and family adversity with lower earnings in all models. A 1-SD reduction in inattention at age 6 years was associated with a theoretical increase in annual earnings of $3040.41, a similar magnitude to an equivalent increase in IQ., Conclusions and Relevance: Teacher ratings of inattention and prosociality in kindergarten boys from low socioeconomic neighborhoods are associated with earnings in adulthood after adjustment for hyperactivity, aggression, and opposition, which were not associated with earnings. Interventions beginning in kindergarten that target boys' inattention and enhance prosociality could positively impact workforce integration and earnings.

Kenya currently lacks evidence on whether income in the informal sector is sustainable and predictable and therefore able to support financing of universal health coverage (UHC). This article demonstrates the financial potential of informal sector entities to sustainably finance UHC in Kenya. Data were collected using a standardized questionnaire on the following topics: nature and sustainability of informal sector entities, indicators of financial potential, and socioeconomic status. Both descriptive and multivariate analyses were used. The findings indicate that income in the informal sector is generally low although investors in health/medical, stationery, entertainment, manufacturing and craft as well as transportation tend to have higher and more consistent incomes than most others in both sites. Mean monthly incomes ranged from 16.7 USD (lowest) to 786.5 USD (highest). The urban informal sector recorded higher mean monthly incomes of 195.8 USD compared to 77.9 USD in the rural area ( P < 0.001). The most sustainable entities in the urban area included stationery (67%), repair and maintenance (50%), food vending (49%), shopkeeping (48%), and clothing and beauty products (43%). Farming (90%), manufacturing and craft (86%), and health/medical (100%) were the most sustainable in the rural area. Key predictors of sustainable informal sector entities include monthly expenditure patterns, gender, marital status, household structure, number of employees in an entity, and land ownership in the rural area and number of entities owned. Informal sector entities are mostly unsustainable, meaning that the majority of premium contributors will not be consistent in payment and will likely to require subsidies.

Objective: To understand views of adolescent and adult caregivers on integrating employment and financial services into a pediatric primary care clinic serving low-income families., Methods: Eighteen in-depth qualitative interviews were conducted among caregivers of pediatric patients. Participants were recruited from those who completed a survey assessing financial and employment needs. Audio-recorded transcripts were analyzed using line-by-line coding of emerging themes., Results: Adolescent and adult caregivers expressed difficulty managing financial stress. They cited having a criminal history, limited financial literacy, and lack of available quality jobs as barriers to achieving financial stability. A clinic-based employment and financial program was highly acceptable among potential users for the convenience it offers and the established trust and understanding between patients and clinical providers. Participants preferred one-on-one counseling for sensitive employment and financial issues, although they did believe that some topics, such as building a resume, could be accomplished in group workshops., Conclusions: Caregivers attending a pediatric clinic expressed interest in and anticipated value from clinic-based employment and financial services if implemented services are relevant, accessible, and provide options for group and individualized approaches., (Copyright © 2018 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.)