The Integrated State

Author(s):  
Charley E. Willison

San Francisco represents municipalities with a local supportive housing policy. San Francisco highlights the significance of policy implementation as a critical process that cannot be overlooked when examining policy success. San Francisco should seemingly be very well positioned to successfully tackle chronic homelessness compared to other cities across the United States with a centralized municipal Continuum of Care, strong local tax base, and historical investment in social and health services for at-risk groups. Yet, many efforts have stagnated at the implementation phase. San Francisco is a city with a very visible homelessness epidemic. The problem will not be solved until implementation problems can be overcome by improving participatory equity in political decision-making to include minorities and at-risk groups, limiting elected officials’ ability to interfere with bureaucrats’ duties to carry out supportive housing regulation, and improving state level coordination with municipal goals to reduce administrative burden and align funding mechanisms.

Author(s):  
Charley E. Willison

Chapter 4 examines national variation in municipal responses to chronic homelessness, identifying the prevalence of municipal-level supportive housing policies among municipalities affected by homelessness in the United States and identifying and examining factors associated with the presence of a municipal-level supportive housing policy. The presence of municipal-level supportive housing policies is an indication of evidence-based policy adoption to address chronic homelessness effectively in urban areas. To date, there has been almost no research on the political predictors of the adoption of these evidence-based policies. Results demonstrate that most municipalities facing homelessness challenges do not have supportive housing policies. Of the municipalities in the data set, only 40% had a municipal-level supportive housing policy. These municipalities tend to be: more liberal; sanctuary cities; have fewer but better funded nonprofit health organizations; lower rates of municipal governmental fragmentation; and located in states without Medicaid expansion.


2003 ◽  
Vol 163 (3) ◽  
pp. 286 ◽  
Author(s):  
Alessio Fasano ◽  
Irene Berti ◽  
Tania Gerarduzzi ◽  
Tarcisio Not ◽  
Richard B. Colletti ◽  
...  

2021 ◽  
pp. 167-180
Author(s):  
Charley E. Willison

Overcoming challenges associated with decentralization and policy conflict across policy interests to address chronic homelessness in municipalities across the United States will be a big hurdle requiring substantial changes. Primary recommendations for reform include, first, aligning Continuums of Care with municipal government to ensure Continuums have access to necessary resources and governmental authority to design and implement policy across the variety of policy spaces including housing, healthcare, behavioral health, policing, and incarceration. Second, improving participatory equity in homeless policy decision-making to include minority groups and persons who are currently or formerly homeless will improve policy design and implementation to ensure policies targeting persons experiencing homelessness work to their intended goals and protect policy processes from bias toward economic elite stakeholders in pluralistic settings. Lastly, steps are recommended to align tangential state-level policies providing services for persons experiencing chronic homelessness but, by virtue of not being designed to target chronic homelessness, fail in implementation.


2017 ◽  
Vol 40 (2) ◽  
pp. 415-418 ◽  
Author(s):  
Benjamin F Henwood ◽  
John Lahey ◽  
Harmony Rhoades ◽  
Hailey Winetrobe ◽  
Suzanne L Wenzel

Abstract Background Permanent supportive housing (PSH) has been recognized as an effective intervention and the national policy for addressing chronic homelessness in the United States. Due to an aging cohort of homeless adults and prioritizing those who are most vulnerable for housing, the health status of those entering PSH is likely worse than those previously reported in the literature. Methods This report examined the self-reported health and health conditions of a sample of 421 homeless adults entering PSH between 2014 and 2016. The average age of our sample was 54 years old. Results Overall, 90% reported two or more chronic conditions (either physical or mental), 68% reported at least two chronic physical health conditions and 56% indicated at least two chronic mental health conditions. Describing their health status, 57% reported fair, poor or very poor health. Conclusions These findings suggest that access to housing will not easily remedy the well-documented premature mortality among chronically homeless adults.


PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0252338
Author(s):  
Anna M. Leddy ◽  
Jennifer M. Zakaras ◽  
Jacqueline Shieh ◽  
Amy A. Conroy ◽  
Ighovwerha Ofotokun ◽  
...  

Background Food insecurity and intimate partner violence (IPV) are associated with suboptimal HIV prevention and treatment outcomes, yet limited research has explored how food insecurity and IPV intersect to influence HIV-related behaviors. To fill this gap, we conducted a qualitative study with women living with or at risk for HIV in the United States. Methods We conducted 24 in-depth interviews with women enrolled in the San Francisco and Atlanta sites of the Women’s Interagency HIV study (WIHS). Participants were purposively sampled so half were living with HIV and all reported food insecurity and IPV in the past year. Semi-structured interviews explored experiences with food insecurity and IPV, how these experiences might be related and influence HIV risk and treatment behaviors. Analysis was guided by an inductive-deductive approach. Results A predominant theme centered on how food insecurity and IPV co-occur with poor mental health and substance use to influence HIV-related behaviors. Women described how intersecting experiences of food insecurity and IPV negatively affected their mental health, with many indicating using substances to “feel no pain”. Substance use, in turn, was described to perpetuate food insecurity, IPV, and poor mental health in a vicious cycle, ultimately facilitating HIV risk behaviors and preventing HIV treatment adherence. Conclusions Food insecurity, IPV, poor mental health and substance use intersect and negatively influence HIV prevention and treatment behaviors. Findings offer preliminary evidence of a syndemic that goes beyond the more widely studied “SAVA” (substance use, AIDS, and violence) syndemic, drawing attention to additional constructs of mental health and food insecurity. Quantitative research must further characterize the extent and size of this syndemic. Policies that address the social and structural drivers of this syndemic, including multi-level and trauma-informed approaches, should be implemented and evaluated to assess their impact on this syndemic and its negative health effects.


2021 ◽  
pp. 089011712110445
Author(s):  
Pamela Schwartz ◽  
Jennifer L. Sedillo ◽  
Jessica L.C. Sapp

Purpose To evaluate using Facebook ads to promote hepatitis A vaccination to at-risk groups. Design This descriptive research study used Facebook ads and posts to deliver a social media health campaign. Setting The social networking site Facebook was used to target audiences in the United States. Subjects Adults in the United States with Facebook accounts were the general audience with at-risk audiences having interests or profile attributes in either LGBTQ or food service groups. Measures Facebook Ads Manager was used to determine impressions, engagement rates, link clicks, and cost per result of the ads. These metrics were measured to examine the use of Facebook ads and targeting audiences. Analysis Quantitative data were analyzed using descriptive statistics, and the Pearson correlation coefficient analysis was used to determine if the amount spent on each ad had any correlation with reach, results, cost per result, or impressions. Results The campaign resulted in a reach of 53 422 users, 70 542 impressions, 457 unique link clicks (483 link clicks), an average cost per results of $0.92 USD, and the total amount spent of $445.68 USD. The amount spent was positively correlated with reach (r = .969), results (r = .994), cost per result (r = .841), and impressions (r =.957). Conclusion The social media health campaign was effective in reaching an audience about hepatitis A vaccination. Using interest groups was not more cost-effective than a using a general audience for link clicks.


Author(s):  
Benjamin Gonzalez O'Brien

Sanctuary policies first emerged in the 1980s as a response to the Reagan administration’s denial of asylum claims for refugees from Guatemala and El Salvador. In response to a growing refugee crisis, and the fear that many of those who were being denied asylum faced persecution and death in their country of origin, churches and synagogues began offering “sanctuary” to refugees from these countries, based on ancient religious tradition. The Sanctuary Movement, as it came to be known, led a number of cities to adopt city resolutions in solidarity beginning in 1983, marking the birth of the sanctuary city. These policies forbade local officials from inquiring into the immigration status of residents and often criticized the Reagan administration’s refugee policies. Today, the scope of sanctuary policies has expanded, and they may not only bar local officials from collecting information on immigration status, but also include a refusal to honor immigration detainers from Immigration and Customs Enforcement (ICE), which are issued by ICE to request that local authorities hold immigrants until they can be taken into federal custody for deportation proceedings. Most sanctuary policies in the United States were passed during three periods. The first ran from 1983 to 1989, with the policies passed in response to the Central American refugee crisis. The September 11 attacks and the subsequent immigration crackdown and passage of policies like Secure Communities would lead to more policies being passed between 2001 and 2012. Lastly, the presidency of Donald Trump led to more declarations based on the administration’s crackdown on undocumented immigration. At the same time, an anti-sanctuary movement materialized for the first time at both the federal and state level that sought to either prevent further declarations or to attach penalties to sanctuary policies. One example is Texas’s SB 4, which in 2017 introduced state-wide bans on these policies and allows for fines and removal from office for officials who do not comply with federal immigration policy. The Trump administration itself sought to deny federal grants to sanctuary jurisdictions, something that had been floated in the past by Republican presidential candidates like Fred Thompson but had never been attempted by previous administrations. The rhetoric of the Trump administration on sanctuary policies, as well as the media coverage of the 2015 accidental shooting of Kathryn Steinle in San Francisco by an undocumented immigrant led to more coverage of the topic than at any other point in history. This in turn led to increased scholarship, which continues, as researchers look to connect the Sanctuary Movement to modern sanctuary cities; to examine the effects of media framing of these policies; to analyze the causes of public support or opposition; to explore the legality of sanctuary and anti-sanctuary legislation; and to document the effects these policies have on the incorporation of immigrant communities and crime rates in sanctuary cities.


2015 ◽  
Vol 10 (3) ◽  
pp. 242-274 ◽  
Author(s):  
Kenneth G. Elzinga ◽  
Carol Horton Tremblay ◽  
Victor J. Tremblay

AbstractWe provide a mini-history of the craft beer segment of the U.S. brewing industry with particular emphasis on producer-entrepreneurs but also other pioneers involved in the promotion and marketing of craft beer who made contributions to brewing it. In contrast to the more commodity-like lager beer produced by the macrobrewers in the United States, the output of the craft segment more closely resembles the product differentiation and fragmentation in the wine industry. We develop a database that tracks the rise of craft brewing using various statistical measures of output, number of producers, concentration within the segment, and compares output with that of the macro and import segment of the industry. Integrating our database into Geographic Information Systems software enables us to map the spread of the craft beer segment from its taproot in San Francisco across the United States. Finally, we use regression analysis to explore variables influencing the entrants and craft beer production at the state level from 1980 to 2012. We use Tobit estimation for production and negative binomial estimation for the number of brewers. We also analyze whether strategic effects (e.g., locating near competing beer producers) explain the location choices of craft beer producers. (JEL Classifications: L26, L66, N82, R12)


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