Copyright (c) 2009 All rights reserved. http://works.bepress.com/christine_eibner Recent documents in Christine Eibner en-us Sun, 31 May 2009 04:24:04 PDT 3600 http://works.bepress.com/christine_eibner/9 http://works.bepress.com/christine_eibner/9 Wed, 29 Oct 2008 12:57:15 PDT Data from the Employment Cost Index show that health insurance costs relative to payroll increased 34 percent between 1996 and 2005 and that the increase was largest for businesses paying low wages; simultaneously, data from the Employee Benefits Survey show that benefit packages became less generous, yet cost growth was not paralleled by a commensurate decrease in employer offers. Christine Eibner http://works.bepress.com/christine_eibner/7 http://works.bepress.com/christine_eibner/7 Thu, 17 Apr 2008 13:21:08 PDT Christine Eibner http://works.bepress.com/christine_eibner/6 http://works.bepress.com/christine_eibner/6 Thu, 17 Apr 2008 12:28:38 PDT This paper uses cross-sectional data from the HealthCare for Communities (HCC) study to investigate whether an individual's income status relative to a reference group predicts mental health outcomes. Reference groups are defined using combinations of location of residence, age, marital status, sex, and education. Our measure of relative deprivation is based on Yitzhaki's index, a term that quantifies the expected income difference between an individual and others in his or her reference group who are more affluent. Even after controlling for an individual's absolute income status, those with low relative income are at higher risk of experiencing a mental health disorder. Results are strongest when age in addition to location of residence is included in the reference group definition. Christine Eibner http://works.bepress.com/christine_eibner/5 http://works.bepress.com/christine_eibner/5 Wed, 16 Apr 2008 15:17:55 PDT Using individual-level data on males from the 1988-91 National Health Interview Survey Multiple Cause of Death Files, we examine the impact of relative deprivation within a reference group on health. We define reference groups using combinations of state, race, education, and age. High relative deprivation in the sense of Yitzhaki is associated with a higher probability of death, worse self-reported health, higher self-reported limitations, higher body mass index, and an increased probability of taking health risks. Christine Eibner http://works.bepress.com/christine_eibner/4 http://works.bepress.com/christine_eibner/4 Tue, 15 Apr 2008 17:39:02 PDT In this analysis we create census-tract level indices of area deprivation for the US that parallel similar indices developed in Britain, and we determine whether these indices are related to physical and mental health outcomes. Data for the indices come from the 2000 Census Summary File Tapes and the 2001 Zip Code Business Patterns Files. These indices are then linked by census tract to cross-sectional data from the HealthCare for Communities (HCC) study, and equations are estimated using multi-level models with census-tract random effects. We find that area-level deprivation predicts poor mental and physical health outcomes, but different components of deprivation have different effects. When we measure deprivation using three factor scores that emerged from our analysis (rather than combining all measures of deprivation into a single index), we find that access to services has a more pronounced association with physical health, whereas racial composition and local language barriers are more strongly correlated with mental health. These findings suggest that grouping all variables into a single index may mask important heterogeneity in the ways in which area characteristics affect health outcomes. 2005 Elsevier Ltd. All rights reserved. Christine Eibner http://works.bepress.com/christine_eibner/3 http://works.bepress.com/christine_eibner/3 Tue, 15 Apr 2008 16:59:48 PDT This study reports results from an evaluation of the experimental Rio Hondo driving under the influence (DUI) court of Los Angeles County, California. Interviews and official record checks with 284 research participants who were randomly assigned to a DUI court or a traditional criminal court were assessed at baseline and at 24-month follow-up. The interviews assessed the impact of the DUI court on self-reported drunk driving behavior, the completion of treatment, time spent in jail, alcohol use, and stressful life events. Official record checks assessed the impact of the DUI court on subsequent arrests for driving under the influence and other drinking-related behaviors. Few differences on any outcomes were observed between participants in the experimental DUI court and those assigned to the traditional court. The results suggest that the DUI court model had little additional therapeutic or public safety benefit over the traditional court process. The implication of these findings for the popularity of specialized courts for treating social problems is discussed. Christine Eibner http://works.bepress.com/christine_eibner/2 http://works.bepress.com/christine_eibner/2 Fri, 11 Apr 2008 17:53:42 PDT We assessed the cost-effectiveness of the Rio Hondo driving-under-the-influence (DUI) court, a therapeutic court intervention in Los Angeles County targeted to repeat DUI offenders. The effectiveness of this court intervention was determined through a randomized controlled field experiment. Although prior research does not identify differences in alcohol-related or criminal behavior between treated and control individuals at follow-up, we found improvements in behavior for all program participants regardless of treatment status. A cost minimization analysis found that, on average, cost of the DUI court exceeded traditional court expenditures for second-time offenders but produced cost savings for third-time offenders. This suggests that implementing a DUI-specific court intervention for serious DUI recidivists is a worthwhile investment of public resources. The unique legal treatment of DUI offenders in California may hide additional cost savings that could be accrued in other jurisdictions through the adoption of DUI court programs. © 2006 Elsevier Inc. All rights reserved. Christine Eibner http://works.bepress.com/christine_eibner/1 http://works.bepress.com/christine_eibner/1 Tue, 08 Apr 2008 17:58:46 PDT Using a multivariate framework, we analyze recent trends in employer provision of retiree health insurance (RHI), eligibility for new retirees, and retiree contribution requirements. We also explore whether local labor market characteristics such as the unemployment rate influence RHI provision. Finally, we examine whether the Medicare Modernization Act (MMA) was associated with diverging trends in RHI access for Medicare-eligible and early retirees. Data come for the Medical Expenditure Panel Survey--Insurance Component (MEPS-IC). We find that, while RHI provision to existing retirees remained stable, eligibility for new retirees declined, and contribution requirements increased between 2000 and 2004. The local labor market had no effect on RHI provision. While early retiree coverage was more common than coverage for Medicare-eligible retirees, we did not find a divergence subsequent to MMA. These results suggest growing financial instability for retirees, both because RHI contribution requirements increased, and because businesses dropped coverage for new retirees.The authors thank Carole Roan Gresenz and M. Susan Marquis for invaluable guidance in developing this project, and Randy Becker for numerous insightful comments on a preliminary draft. We also thank Arnold Reznek, Anurag Singal, and Ann Schatzer for support at the Census Bureau's Research Data Center. This research was funded by the U.S. Department of Labor. Christine Eibner