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Articles 91 - 120 of 917

Full-Text Articles in Social Work

Using Constructivist Grounded Theory To Generate Participatory Research Empowerment Guideposts (Pregs) For African American Communities To Address Racial Health Disparities, Helen Irene Thurman May 2024

Using Constructivist Grounded Theory To Generate Participatory Research Empowerment Guideposts (Pregs) For African American Communities To Address Racial Health Disparities, Helen Irene Thurman

Brown School Graduate Student Theses and Dissertations

Racism has multi-systemic impacts on African Americans resulting in longstanding racial health disparities. Increasingly, researchers use participatory research in their health equity efforts. Participatory research is rooted in the principle of empowerment and centers community lived experience to generate meaningful solutions while shifting conventionally held positions of power within research engagement and within systems more broadly. Yet the research literature on empowerment lacks consensus of its operationalization and measurement. What’s more, it is unclear to what degree existing frameworks of empowerment are derived from the communities they seek to engage and empower. Thus existing frameworks of empowerment could be strengthened …


Child Savings Accounts And Other Tax-Advantaged Accounts Benefiting American Children: Testimony Before The U.S. Senate Committee On Finance, William Elliott May 2024

Child Savings Accounts And Other Tax-Advantaged Accounts Benefiting American Children: Testimony Before The U.S. Senate Committee On Finance, William Elliott

Center for Social Development Research

This Perspective presents testimony given by Dr. William Elliott during “Child Savings Accounts and Other Tax-Advantaged Accounts Benefiting American Children,” a hearing before the U.S. Senate Committee on Finance, on May 21, 2024. Noting findings from children’s account research―including findings from the SEED for Oklahoma Kids experiment conducted by the Center for Social Development―Dr. Elliott discusses the 401Kids Savings Account Act and the American Opportunity Accounts Act, as well as proposals for Child Savings Accounts, Baby Bonds, Child Development Accounts.


Navigating Gendered Racism Through Coping And Radical Healing: An Interpretative Phenomenological Analysis Of Black Women’S Mental Health In Doctoral Programs, Phylicia Keys May 2024

Navigating Gendered Racism Through Coping And Radical Healing: An Interpretative Phenomenological Analysis Of Black Women’S Mental Health In Doctoral Programs, Phylicia Keys

Brown School Graduate Student Theses and Dissertations

Gendered racism emerges as a pervasive mental health concern among Black women doctoral students. However, there is a scarcity of existing literature on the strategies being used to maintain mental well-being while navigating gendered racism among Black women doctoral students. To address the current gaps in scientific knowledge, this dissertation completed individual semi-structured interviews. Interpretative Phenomenological Analysis (IPA), and the lens of Black Feminist Thought and Intersectionality were used as guiding theoretical frameworks to examine narratives of fifteen Black women doctoral students at universities in the United States. The study findings provided insight into coping strategies and the role of …


Impact Of Parent Reported Adverse Experiences And Other Family Stressors On Child Development And Home Visitation Participation Among Immigrant Families, Fithi Andom May 2024

Impact Of Parent Reported Adverse Experiences And Other Family Stressors On Child Development And Home Visitation Participation Among Immigrant Families, Fithi Andom

Brown School Graduate Student Theses and Dissertations

This dissertation examines variations in early childhood developmental and socioemotional health as well as level of participation in home visitation among recent immigrant families according to reports of adverse experiences (including poverty, intimate partner violence (IPV), and prior history of child protective services (CPS) involvement), maternal depression, and parent–child relationship measures. The period of early childhood is dependent on positive parenting to support optimum development, but parenting may be particularly sensitive to the detrimental influences of adverse experiences. Less is known about how the relationship between parenting, adverse experiences, and child development may differ for immigrant families. Home visitation has …


Perspectives Of Stress And Coping Among Older, College-Educated African American Women, Jacquelyn Victoria Coats May 2024

Perspectives Of Stress And Coping Among Older, College-Educated African American Women, Jacquelyn Victoria Coats

Brown School Graduate Student Theses and Dissertations

Older African American women have excess rates of stress-associated chronic diseases. Yet, there is limited research exploring the intersectional position of older African American women to identify within-group differences in stress experiences. Specifically, stress and coping among college-educated women in later life has been largely overlooked. As trends show increasing rates of African American women attaining higher education, research investigating stress and coping among this group of high socio-economic status women is a valuable contribution to aging and public health. This study employed constructivist grounded theory methods guided by the Intersectional Life Course Perspective and the Transactional Model of Stress …


Dual-System Youth And Emancipating From Foster Care: Examining The Relations Between Delinquency, Independent Living Services, And Criminal Justice Involvement, Dylan Monahan Jones May 2024

Dual-System Youth And Emancipating From Foster Care: Examining The Relations Between Delinquency, Independent Living Services, And Criminal Justice Involvement, Dylan Monahan Jones

Brown School Graduate Student Theses and Dissertations

Youth who touch both the child welfare system (CWS) and juvenile justice system (JJS), termed dual-system youth, represent a particularly high needs population at risk of poor outcomes into adulthood. Among CWS involved children, youth aging out of foster care are particularly high risk of dual-system status. To help these teenagers in foster care prepare for adulthood, states offer independent living services (ILS). Despite the high risk of JJS involvement of these youth, we know very little of the association between ILS receipt and dual-system involvement. This dissertation has two aims, the first focusing on ILS and delinquency onset during …


Lifecourse Patterns Of Productive Engagement Among Rural And Urban Older Adults, Peter C. Sun May 2024

Lifecourse Patterns Of Productive Engagement Among Rural And Urban Older Adults, Peter C. Sun

Brown School Graduate Student Theses and Dissertations

Many older adults are engaged in productive activities that have important ramifications for health in later life. However, little is known about rural-urban patterns of productive engagement across the lifecourse. This dissertation used six waves (2008, 2010, 2012, 2014, 2016, 2018) of the nationally representative Health and Retirement Study to identify patterns of working, volunteering, and caregiving activities over a ten-year period using multichannel sequence analysis and cluster analysis. The antecedents of the patterns were studied using multinomial logistic regression, and the associations of the patterns with longstanding rural-urban disparities in cognitive functioning and self-rated health were studied using multiple …


Wealth-Building For All Children: Convergence And Evidence To Support A Nationwide Policy, Jin Huang, Trina R. Shanks, Margaret M. Clancy, William Elliott Iii, Michael Sherraden Apr 2024

Wealth-Building For All Children: Convergence And Evidence To Support A Nationwide Policy, Jin Huang, Trina R. Shanks, Margaret M. Clancy, William Elliott Iii, Michael Sherraden

Center for Social Development Research

Amid growing concern about wealth inequality in the United States, many policymakers and researchers have come to see early-life wealth-building policies as potential remedies. This brief discusses convergence in the policy community around a shared vision and principles for such policy, and it connects that vision to research. Child Development Account research, much of it conducted through CSD’s SEED for Oklahoma Kids experiment, suggests the parameters for an inclusive, efficient, and effective policy that would express the community’s shared vision.


Report On A Seminar On Financial Capability And Asset Building Organised For Social Work Practitioners, Augustina Naami, Mavis Dako-Gyeke, Abigail A. Mills, Abena Ampomah Mar 2024

Report On A Seminar On Financial Capability And Asset Building Organised For Social Work Practitioners, Augustina Naami, Mavis Dako-Gyeke, Abigail A. Mills, Abena Ampomah

Center for Social Development Research

A key step in the work to improve the financial stability and security of marginalized populations begins with training social work practitioners and other human service professionals for competencies in supporting families to build financial security and freedom. In September 2023, the Department of Social Work at the University of Ghana collaborated with the School of Social Work at the University of North Carolina at Chapel Hill to organize a seminar on financial capability and asset building (FCAB) for practitioners in Accra, Ghana. As part of the seminar, Faculty Director David Ansong discussed CSD’s FCAB Africa initiative. This report provides …


Reflections, Accomplishments, And Opportunities: The Csd Annual Letter, Michael Sherraden Jan 2024

Reflections, Accomplishments, And Opportunities: The Csd Annual Letter, Michael Sherraden

Center for Social Development Research

In this annual letter to mark the start of the Center's for Social Development's 30th year, Founding Director Michael Sherraden shares reflections on some recent accomplishments and discusses the opportunities ahead.


Approaches To Charitable Giving And Perceptions Of Organizational Effectiveness Among Midlevel Donors, Cal J. Halvorsen, Johanna Lynch, Sylvia Brown, Melissa L. Mcternan Jan 2024

Approaches To Charitable Giving And Perceptions Of Organizational Effectiveness Among Midlevel Donors, Cal J. Halvorsen, Johanna Lynch, Sylvia Brown, Melissa L. Mcternan

Harvey A. Friedman Center for Aging

For decades, scholars have devoted attention to identifying the giving habits of charitable donors, yet the behaviors of midlevel donors have not been independently considered. This study examined midlevel donors’ approaches to charitable giving and the extent to which they give to effective organizations. Operationalized as giving between $2,000 and $20,000 annually, we analyzed descriptive statistics and multivariate probit models of 1,260 midlevel donors using a novel study. We found that respondents were least likely to engage in ad-hoc giving and most likely to give to organizations due to personal connections or prior research. However, while caring about a cause …


My Alfond Grant Cda: Experience From 10 Years Of Automatic Deposits For All Maine Newborns, Colleen J. Quint, Margaret M. Clancy Jun 2023

My Alfond Grant Cda: Experience From 10 Years Of Automatic Deposits For All Maine Newborns, Colleen J. Quint, Margaret M. Clancy

Center for Social Development Research

For over a decade, the Alfond Scholarship Foundation has automatically enrolled every Maine-resident newborn into the United States’ first statewide, universal Child Development Account (CDA) by investing $500 on each child’s behalf in the NextGen 529 plan. This Policy Brief provides an overview of My Alfond Grant and tracks the growth of the CDA in the 10 years since it made the major policy-design change to implement automatic enrollment. The Brief also includes insights regarding partnerships and communications that have helped to improve My Alfond Grant’s ability to connect with Maine families.


Child Well-Being Policies In Post-Soviet Countries: The Potential Of Child Development Accounts, Aytakin Huseynli, Michael Sherraden Jun 2023

Child Well-Being Policies In Post-Soviet Countries: The Potential Of Child Development Accounts, Aytakin Huseynli, Michael Sherraden

Center for Social Development Research

Following the collapse of the Soviet Union, all post-Soviet countries initiated reforms in child well-being systems. Some have undertaken meaningful changes, and others continue to struggle. This Policy Brief summarizes one portion of an in-depth study on child well-being policies in six post-Soviet countries: Ukraine, Moldova, Azerbaijan, Georgia, Kazakhstan, and Kyrgyzstan. It discusses asset-building policy for children in those countries, an emerging national children’s account policy in Kazakhstan, and the potential for diffusion of Child Development Account policy.


Homegrown Stl 5th Annual Regional Summit On The State Of Opportunity For Black Boys And Young Men: Organizing For Solutions That Unleash The Elite Potential Of Young Black Males, Sean Joe, Maribeth Clifton, Demeisha Carlton-Brown May 2023

Homegrown Stl 5th Annual Regional Summit On The State Of Opportunity For Black Boys And Young Men: Organizing For Solutions That Unleash The Elite Potential Of Young Black Males, Sean Joe, Maribeth Clifton, Demeisha Carlton-Brown

Center for Social Development Research

Convened annually, HomeGrown StL’s annual regional summit brings together service providers, government officials, private-sector partners, and residents to strengthen, align, and accelerate local collective-impact strategies that support the health, development, and economic mobility of Black boys and young men in St. Louis City and in St. Louis County.

This report summarizes developments from the 5th Regional Summit on the State of Opportunity for Black Boys and Young Men: Organizing for Solutions That Unleash the Elite Potential of Young Black Males, which convened June 9, 2022. In addition to describing Priority Objectives and Key Results developed during the summit, the report …


Expanded Child Tax Credit Payments Supported Families Raising Children With Disabilities, Allyson Baughman, Laura Brugger, Meg Comeau, Leah Hamilton, Candace Jarzombek, Caroline Parker, Stephen Roll Mar 2023

Expanded Child Tax Credit Payments Supported Families Raising Children With Disabilities, Allyson Baughman, Laura Brugger, Meg Comeau, Leah Hamilton, Candace Jarzombek, Caroline Parker, Stephen Roll

Social Policy Institute Research

The 2021 expanded Child Tax Credit (CTC) provided temporary enhancements to the existing CTC for the tax years 2021 and 2022. Under the expanded credit, families with children under the age of 18 were eligible to receive a credit of up to $3,000 per child ($3,600 for children under the age of 6).

In addition, half the credit was paid out on a monthly basis rather than as a one-time payment at tax time. This provision was designed to provide more immediate financial support to families with children during the COVID-19 pandemic. However, it also supported families who were at …


“It Helped Us More Than I Could Have Imagined”: How The 2021 Expanded Child Tax Credit Supported Families Raising Children With Disabilities, Laura Brugger, Stephen Roll, Leah Hamilton, Allyson Baughman, Meg Comeau, Candace Jarzombeck, Caroline Parker Mar 2023

“It Helped Us More Than I Could Have Imagined”: How The 2021 Expanded Child Tax Credit Supported Families Raising Children With Disabilities, Laura Brugger, Stephen Roll, Leah Hamilton, Allyson Baughman, Meg Comeau, Candace Jarzombeck, Caroline Parker

Social Policy Institute Research

The 2021 expanded Child Tax Credit (CTC) provided temporary enhancements to the existing CTC for the tax years 2021 and 2022. Under the expanded credit, families with children under the age of 18 were eligible to receive a credit of up to $3,000 per child ($3,600 for children under the age of 6). In addition, half the credit was paid out on a monthly basis rather than as a one-time payment at tax time. This provision was designed to provide more immediate financial support to families with children during the COVID-19 pandemic. However, it also supported families who were at …


Linkage Fees: A Vehicle For Financing Affordable Housing, Lillian Murphy, Stanford Cooper, Russell Beckham Feb 2023

Linkage Fees: A Vehicle For Financing Affordable Housing, Lillian Murphy, Stanford Cooper, Russell Beckham

Center for Social Development Research

A linkage fee is a policy instrument for capturing resources to fund affordable housing development and other public services. This brief describes the instrument and offers recommendations on implementing linkage-fee policies.

The contents of this brief evolved from a presentation given in the Colloquium on Inclusive Housing Policy for the St. Louis Region. Held in the Brown School at Washington University on December 15, 2022, the event was organized by the Center for Social Development in partnership with Women’s Voices Raised for Social Justice and the Alliance for Interracial Dignity. The contents may also be found in Welcome Home: A …


Racially Restrictive Covenants: A Story Of Segregation, Disinvestment, And Lingering Implications, Fadya Al Hammam, Janeka Haden, Livi Logan-Wood, Joseph Roeder Feb 2023

Racially Restrictive Covenants: A Story Of Segregation, Disinvestment, And Lingering Implications, Fadya Al Hammam, Janeka Haden, Livi Logan-Wood, Joseph Roeder

Center for Social Development Research

Racially restrictive covenants are agreements, typically embedded in property deeds, that limit the transfer of property to non-white people. The covenants remain common features of property deeds in the St. Louis region, though enforcement of them was outlawed by the U.S. Supreme Court’s Shelley v. Kraemer decision in 1948. This brief discusses the covenants and identifies strategies for communities to deploy in addressing them.

The contents of this brief evolved from a presentation given in the Colloquium on Inclusive Housing Policy for the St. Louis Region. Held in the Brown School at Washington University on December 15, 2022, the event …


Zoning: Issues And Reform, Olivia Borland, Casey Kohlstruk, Lindsay Owens Feb 2023

Zoning: Issues And Reform, Olivia Borland, Casey Kohlstruk, Lindsay Owens

Center for Social Development Research

What steps can communities take to broaden equitable access to housing and prevent residential displacement? This brief identifies strategies for reforming zoning policy to advance those goals.

The contents of this brief evolved from a presentation given in the Colloquium on Inclusive Housing Policy for the St. Louis Region. Held in the Brown School at Washington University on December 15, 2022, the event was organized by the Center for Social Development in partnership with Women’s Voices Raised for Social Justice and the Alliance for Interracial Dignity. The contents may also be found in Welcome Home: A Policy Briefing Book for …


Advancing Racial Equity Through Community Land Trusts, Amal Alzhrani, Brittany Kiefer, Da-Yup Kim, Gabby Eissner Feb 2023

Advancing Racial Equity Through Community Land Trusts, Amal Alzhrani, Brittany Kiefer, Da-Yup Kim, Gabby Eissner

Center for Social Development Research

Community land trusts are nonprofit organizations designed to preserve housing affordability. This brief describes the design and operation of such trusts, illustrating the concept by spotlighting the Columbia Community Land Trust of Columbia, Missouri.

The contents of this brief evolved from a presentation given in the Colloquium on Inclusive Housing Policy for the St. Louis Region. Held in the Brown School at Washington University on December 15, 2022, the event was organized by the Center for Social Development in partnership with Women’s Voices Raised for Social Justice and the Alliance for Interracial Dignity. The contents may also be found in …


Welcome Home: A Policy Briefing Book For Housing Opportunity In St. Louis County, Molly W. Metzger Feb 2023

Welcome Home: A Policy Briefing Book For Housing Opportunity In St. Louis County, Molly W. Metzger

Center for Social Development Research

“Equality of opportunity” is a beautiful American ideal, but it stands in stark relief to the history of racist policies in the United States—including policies in the St. Louis region. Edited by Molly Metzger, this briefing book aims to broaden opportunity by offering ideas for housing policy change in the majority-white, inner-ring suburbs of St. Louis. The policy works in this collection were written by masters of social work students at Washington University’s Brown School as part of a social-policy course taught by Metzger in partnership with Mayor Laura Arnold of Webster Groves, Missouri, Webster Groves’ Alliance for Interracial Dignity, …


Double Burden Of Malnutrition Workshop Facilitation Manual: Lima, Peru, Carmen Quinteros-Reyes, Pavarskevi Seferidi, Laura Guzman-Abello, Christopher Millett, Antonio Bernabé-Ortiz, Lindsey Pawlowski, Ellis Ballard Jan 2023

Double Burden Of Malnutrition Workshop Facilitation Manual: Lima, Peru, Carmen Quinteros-Reyes, Pavarskevi Seferidi, Laura Guzman-Abello, Christopher Millett, Antonio Bernabé-Ortiz, Lindsey Pawlowski, Ellis Ballard

Social System Design Lab

This is a facilitation manual for workshops in Lima, Peru as part of the project “Addressing the double burden of malnutrition in Peru: using a community-based system dynamics approach to improve food systems”. The project is a collaboration between investigators at the Center of Excellence in Chronic Diseases (CRONICAS) at the University of Peruana Cayetano Heredia, Universidad de los Andes in Bogota, Peru, the Social System Design Lab at Washington University in St. Louis, USA and Imperial College London funded by the Biotechnology and Biological Science Research Council (Grant Ref: BB/T009004/1). It is a supplemental document associated with the paper …


Double Burden Of Malnutrition Workshop Facilitation Manual: Iquitos, Peru, Carmen Quinteros-Reyes, Paraskevi Seferidi, Laura Guzman-Abello, Christopher Millett, Antonio Bernabé-Ortiz, Lindsey Pawloski, Ellis Ballard Jan 2023

Double Burden Of Malnutrition Workshop Facilitation Manual: Iquitos, Peru, Carmen Quinteros-Reyes, Paraskevi Seferidi, Laura Guzman-Abello, Christopher Millett, Antonio Bernabé-Ortiz, Lindsey Pawloski, Ellis Ballard

Social System Design Lab

This is a facilitation manual for workshops in Lima, Peru as part of the project “Addressing the double burden of malnutrition in Peru: using a community-based system dynamics approach to improve food systems”. The project is a collaboration between investigators at the Center of Excellence in Chronic Diseases (CRONICAS) at the University of Peruana Cayetano Heredia, Universidad de los Andes in Bogota, Peru, the Social System Design Lab at Washington University in St. Louis, USA and Imperial College London funded by the Biotechnology and Biological Science Research Council (Grant Ref: BB/T009004/1). It is a supplemental document associated with the paper …


The Cogenerate Innovation Fellowship: Supporting Leaders Of Intergenerational Initiatives, Cal J. Halvorsen, Eunice Lin Nichols, Janet Oh Jan 2023

The Cogenerate Innovation Fellowship: Supporting Leaders Of Intergenerational Initiatives, Cal J. Halvorsen, Eunice Lin Nichols, Janet Oh

Harvey A. Friedman Center for Aging

This Case Report provides a detailed overview of the CoGenerate Innovation Fellowship, a 9-month fellowship that supports leaders of intergenerational initiatives developed by the national nonprofit organization, CoGenerate. It describes the Fellowship’s recruitment and cohort development strategies, monthly meetings and community-building efforts, end-of-Fellowship celebration, and post-Fellowship support. It summarizes findings from the two-year pilot’s process and outcomes evaluation and provides recommendations to individuals and organizations seeking to support social sector innovators who are leading intergenerational initiatives.


Effectiveness Of Community Development Organizations In The St. Louis Metropolitan Area, Kyle Pitzer Dec 2022

Effectiveness Of Community Development Organizations In The St. Louis Metropolitan Area, Kyle Pitzer

Brown School Graduate Student Theses and Dissertations

Concentrated poverty has been a core issue in urban America for close to half of a century. The consequences of living in these neighborhoods are also dire. These "neighborhood effects" are defined as the effects of living in concentrated poverty over and above individual circumstances, which have been tied to a number of important life outcomes. One approach to addressing these issues is community development, and perhaps the most salient vehicle of community development is the community development corporation (CDC). This current study sought to address three aims: 1), understand the effects of CDCs on population-level outcomes; 2), understand the …


Financial Well-Being Of Frontline Healthcare Workers: The Importance Of Employer Benefits, Mathieu Despard, Sophia Fox-Dichter, Haotian Zheng, Grace Anderson, Olivia Borland, Kourtney Gilbert Nov 2022

Financial Well-Being Of Frontline Healthcare Workers: The Importance Of Employer Benefits, Mathieu Despard, Sophia Fox-Dichter, Haotian Zheng, Grace Anderson, Olivia Borland, Kourtney Gilbert

Social Policy Institute Research

Frontline healthcare workers – especially direct care workers (DCWs), such as home health aides, struggle due to low pay, lack of benefits, and difficult working conditions. The need for these workers is growing. Unless frontline healthcare jobs improve, positions may be difficult to fill, and care for vulnerable members of society may be compromised.

In this study, we surveyed 2,321 frontline healthcare workers and conducted in-depth interviews with 30 of these workers concerning pay, benefits, work conditions, and financial well-being. Key survey findings included:

  • Only 39% of workers were eligible for at least four out of five major benefits (e.g., …


Global Child Development Accounts: A “Moon Shot” To Develop Every Child And The Planet, Michael Sherraden, Li Zou Oct 2022

Global Child Development Accounts: A “Moon Shot” To Develop Every Child And The Planet, Michael Sherraden, Li Zou

Center for Social Development Research

The early 21st century has been marked by several global stresses. Effective responses, note Michael Sherraden and Li Zou, require large, bold solutions. In this concept note, they propose a global Child Development Account initiative, a global project for building assets for all children to invest in their full development. The times require audacity, Sherraden and Zou assert, but big changes are possible.


Democratizing The Economy Or Introducing Economic Risk? Gig Work During The Covid-19 Pandemic, Daniel Auguste, Stephen Roll, Mathieu Despard Sep 2022

Democratizing The Economy Or Introducing Economic Risk? Gig Work During The Covid-19 Pandemic, Daniel Auguste, Stephen Roll, Mathieu Despard

Social Policy Institute Research

Though the growth of the gig economy has coincided with increased economic precarity in the new economy, we know less about the extent to which gig work (compared with other self-employment arrangements and non-gig work) may fuel economic insecurity among American households. We fill this gap in the literature drawing on a sample of 4,756 workers from a unique national survey capturing economic hardships among non-standard workers like app-and platform-based gig and other self-employed workers during the COVID-19 pandemic. Results from generalized boosted regression modeling, utilizing machine learning to account for potential endogeneity, demonstrated that gig workers experienced significantly greater …


Usage And Impact Of Benefits Among Frontline Healthcare Workers, Mathieu Despard Sep 2022

Usage And Impact Of Benefits Among Frontline Healthcare Workers, Mathieu Despard

Social Policy Institute Research

We completed a study about frontline healthcare workers – the benefits they get through work and how they are doing financially. This brief provides highlights from our survey to 2,321 workers and interviews with 30 workers.


Combatting Rising Healthcare Costs For Healthier Adults, Alejandra Muñoz-Rivera Aug 2022

Combatting Rising Healthcare Costs For Healthier Adults, Alejandra Muñoz-Rivera

Social Policy Institute Research

In 2020, healthcare expenditures averaged $12,530 per person, up 9.7% from 2019. In 2018, 19% of U.S. households had medical debt with $2,000 being the median amount owed. Over half of adults between 18 to 64 years of age are estimated to experience some form of medical financial hardship including medical bills or debt, stress about medical bills, and delaying or forgoing treatment specifically due to cost. In a 2022 survey of 140 Medicaid and Marketplace members by researchers from the Social Policy Institute (SPI) and the Centene Center of Health Transformation, one-third of respondents reported having unpaid medical bills. …