Inequality and Stratification Commons^™

Thrown Together: Credit Union And Commercial Bank Regulation And Competition In The Consumer Finance Industry, 1960-2015, Grace Cale

Theses and Dissertations--Sociology

This project seeks to assess whether there are meaningful differences between the stability of the Credit Union and Consumer Banking industries before the 1980s, and how both industries’ stability had been affected by subsequent political-economic changes. I also sought to assess if deregulation would make credit union behave at risk levels similar to banks. I initially observed that there was a strong inverse correlation between credit union size and failures, which I argue could be explained by regulatory change. This claim was strengthened by the observation that credit unions had benefitted from certain key forms of deregulation, they were still …

“We Had Become Trailer People”: Stigma, Social Boundary Making, And The Story Of The American Mobile Home Park, Katie M. Founds

Theses and Dissertations--Sociology

Mobile homes and mobile home parks—still most often called trailer parks in common vernacular—occupy a particularly stigmatized position in American culture. A symbolic stand-in for a host of social ills, from bad hygiene and broken families to drug use and loose morals, mobile homes offer affordable housing at a social cost, branding their residents as likewise deficient. This piece of material culture did not come into being with such negative meanings attached. The process of becoming a symbol of stigma is an historical one, a story of meaning making in the midst of cultural shifts and changing norms. Since appearing …

It’S Not Just Sunday School: Young Children, Race/Ethnicity, And Gender In Three Homogeneous Protestant Sunday Schools, Henry James Zonio

Theses and Dissertations--Sociology

Current sociological approaches to examining the lives of children approach children as active agents and participants in their socialization. Further, children are considered experts witnesses and interpreters of their own experiences. In the cases of race and gender socialization, interpretive reproduction has been used as a framework to examine how children construct and act on meanings of race and gender. While these interpretive studies illuminate how children interpret and reproduce meanings of race and gender, they do not explicate how children appropriate meanings from their cultural milieu. Consequently, these studies do not consider ways the larger culture enables and constrains …

A Virginia Mountain City Responds To The Challenge Of Improving Health Outcomes, Robert S. Cowell Jr.

Journal of Appalachian Health

In 2012, Roanoke Virginia was becoming a city of haves and have-nots, a place where many were benefitting from revitalization underway but too many were seeing their situation grow worse and becoming even more entrenched. Poverty with levels as high as 50% in some neighborhoods; life expectancy sometimes 14 years shorter than those living just one or two neighborhoods over; and lack of access to fresh food, medical care, and economic opportunities—all within view of the largest hospital in the region was unacceptable.

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Roanoke's Collective Public Health Activities, Michael Lytton

Journal of Appalachian Health

Roanoke is addressing problems that confront many small and medium sized cities in the U.S., especially disparities in health and life expectancy between neighborhoods. These disparities are often legacies of decades of racial and economic segregation, resulting in low-income or disinvested communities. Typically, such neighborhoods have fewer parks, higher vacancy rates and less stable affordable housing stock, inadequate public transit systems, too few clinics, too many fast food restaurants and insufficient access to high quality schools. In Roanoke these are the northwest and southeast quadrants, both federally designated Medically Underserved Areas, and characterized by a large proportion of the city’s …

A Legacy Of Disease, Arthur L. Frank

Journal of Appalachian Health

In Appalachia, like much of America, there are important health issues that have not always been appropriately predicted or dealt with when they occur. Lifestyle issues in Appalachia lead to obesity and heart disease, not surprisingly due to extensive use of sugary drinks. The current opioid crisis could have been better predicted given the trauma of mining and the past abuse of less-potent narcotics. A continuing major problem in the whole country is inadequate support for preventive health activities.

Improving Access To Addiction Recovery Care In Central Appalachia Through Organizational Collaboration, Katy Stigers

Journal of Appalachian Health

Fahe, a Network of 50+ members throughout Appalachia based in Berea KY, has brought together a coalition to finance, build, and manage several addiction recovery care centers across Kentucky and West Virginia, increase access to employment, and deploy vouchers for supportive services.

Disparities In Quality Of Life By Appalachian-Designation Among Women With Breast Cancer, Robin C. Vanderpool, Ann L. Coker, Heather M. Bush, Sarah E. Cprek

Journal of Appalachian Health

Introduction: Few studies have examined the association of geography and quality of life (QOL) among breast cancer patients, particularly differences between Appalachian and non-Appalachian Kentucky women, which is important given the cancer and socioeconomic disparities present in Appalachia.

Purpose: The purpose of this study was to determine whether women with breast cancer residing in Appalachian Kentucky experience poorer health outcomes in regards to depression, stress, QOL, and spiritual wellbeing, relative to those living in non-Appalachian Kentucky after adjusting for demographic, socioeconomic, and health-related factors.

Methods: Women, aged 18–79, recruited from the Kentucky Cancer Registry between 2009 and 2013 with an …

Investigating The Impact Of The Diseases Of Despair In Appalachia, Michael Meit, Megan Heffernan, Erin Tanenbaum

Journal of Appalachian Health

Introduction: Appalachia is one of the regions most significantly impacted by the opioid crisis. This study investigated mortality due to diseases of despair within the Appalachian Region, with an additional focus on deaths attributable to opioid overdose.

Methods: Diseases of despair include: alcohol, prescription drug and illegal drug overdose, suicide, and alcoholic liver disease/cirrhosis of the liver. Mortality data from the National Center for Health Statistics (NCHS) National Vital Statistics System (NVSS) Multiple Cause of Death database were analyzed for this study, focusing on individuals aged 15–64.

Results: Over the past two decades, the mortality rate due to diseases of …

Root Causes Of Appalachia’S Deaths Of Despair, F. Douglas Scutchfield Md

Journal of Appalachian Health

The U.S. is experiencing a decline in life expectancy, particularly among rural white males in their most productive years. Appalachia is disproportionally represented in mortality rates, accounting for 30% of the U.S. population, but 50% of the excess mortality attributed to the “deaths of despair”: drug overdose, suicide, and alcoholic cirrhosis. A substantial proportion of that excess mortality is related to the current opioid crisis we are experiencing. We have data on evidence-based solutions to the treatment of addiction, but little information on prevention of addiction as well as the other deaths of despair, likely with the same etiologic agent. …

Dusty Shoes: Appalachia Wisdom Fertilizing The Future Of Religious Leadership, Jill Crainshaw

Journal of Appalachian Health

Dust from their journeys through the hills and hollows of Appalachia clings to their shoes and has forever shaped their vocational journeys. This is a refrain I have distilled from the reflections of students who have participated in Wake Forest University School of Divinity’s multicultural contexts course that includes a 10-day sojourn in the mountains of North Carolina.

Identifying Priority And “Bright-Spot” Counties For Diabetes Preventive Care In Appalachia: An Exploratory Analysis, Peter J. Mallow, Michael Topmiller, Jennifer Rankin, Jene Grandmont, David Grolling, Jessica L. Mccann, Mark Carrozza

Journal of Appalachian Health

Introduction: Type 2 diabetes mellitus (T2DM) prevalence and mortality in Appalachian counties is substantially higher when compared to non-Appalachian counties, although there is significant variation within Appalachia.

Purpose: The objectives of this research were to identify low-performing (priority) and high-performing (bright spot) counties with respect to improving T2DM preventive care.

Methods: Using data from the Centers for Medicare and Medicaid (CMS), the Dartmouth Atlas of Health Care, and the Appalachia Regional Commission, conditional maps were created using county-level estimates for T2DM prevalence, mortality, and annual hemoglobin A1c (HbA1c) testing rates. Priority counties were identified using the following criteria: top 33rd …

Serum Cotinine Versus Parent Reported Measures Of Secondhand Smoke Exposure In Rural Appalachian Children, Samrat Yeramaneni, Kimberly Yolton, Kurunthachalam Kannan, Kim N. Dietrich, Erin N. Haynes

Journal of Appalachian Health

Background: Secondhand smoke (SHS) exposure in Appalachian children and associated adverse effects is understudied and not well documented. This study assessed the prevalence of SHS exposure in Appalachian children by parental self-report and internal biological measure.

Methods: SHS exposure was determined in children residing in rural Appalachian communities during their participation in the Communities Actively Researching Exposure Study between 2009 and 2013. Parents reported the number of smokers in the household and number of cigarettes smoked/day. Children ages 7-9 provided a serum sample for cotinine analysis. Parent reported measures and child serum cotinine measures of SHS exposure were compared with …

The Social Determinants Of Health And The Decline In U.S. Life Expectancy: Implications For Appalachia, Steven H. Woolf, Heidi Schoomaker, Latoya Hill, Christine M. Orndahl

Journal of Appalachian Health

For the past century, life expectancy in industrialized countries has increased, and the U.S. has shared in that progress. However, beginning in the 1980s, advances in U.S. life expectancy began to lose pace with peer countries. By 1998, U.S. life expectancy had fallen below the average for Organisation for Economic Cooperation and Development nations. U.S. life expectancy peaked in 2014 and has been decreasing for three consecutive years, a trend not been seen since the influenza pandemic a century ago. Put simply, U.S. health is in decline.

Delivering Health Knowledge And Wisdom From The Hills And Hollows Of Appalachia, F. Douglas Scutchfield Md, Erin N. Haynes, Robert M. Shapiro Ii, Charlotte S. Seidman

Journal of Appalachian Health

There is knowledge in the pages of Appalachia’s hills. This journal is positioned to find and publish those translations. It grows from a need to provide an outlet for scholarship about Appalachia’s health so that knowledge, and occasionally wisdom, is shared with those who care about and are committed to improving the region’s health.

The Digital Knowledge Economy Index: Mapping Content Production, Sanna Ojanperä, Mark Graham, Matthew Zook

Geography Faculty Publications

We propose the construction of a Digital Knowledge Economy Index, quantified by way of measuring content creation and participation through digital platforms, namely the code sharing platform GitHub, the crowdsourced encyclopaedia Wikipedia, and Internet domain registrations and estimating a fifth sub-index for the World Bank Knowledge Economy Index for year 2012. This approach complements conventional data sources such as national statistics and expert surveys and helps reflect the underlying digital content creation, capacities, and skills of the population. An index that combines traditional and novel data sources can provide a more revealing view of the status of the world’s digital …

Women Into Advanced Manufacturing: Can Community College Open This Door?, Carissa Bradley Schutzman

Theses and Dissertations--Educational Policy Studies and Evaluation

Women still rarely choose to seek employment in advanced manufacturing. Lack of familiarity with manufacturing jobs and education programs, lack of role models, and too few experiential opportunities contribute to women not choosing manufacturing jobs as well as other jobs traditionally held by men (Reha, Lufkin, & Harrison, 2009; St. Rose & Hill, 2013; Starobin & Laanan, 2008). Nontraditional jobs for women often provide higher wages and more opportunity for advancement than traditional jobs for women. This study is a qualitative thematic narrative analysis of factors that influenced women who chose an advanced manufacturing program at a community college to …

Gay Men And Satisfaction With Health Care Interactions, Michael Huggins

Theses and Dissertations--Nursing

The purpose of this research was to determine relationships among depression, anxiety, self-rated physical and mental health, self-advocacy, internalized homophobia, and quality of patient-provider communication to satisfaction with health care interactions. These were measured while controlling for select demographic variables: age; ethnicity; urban or rural domicile; relationship status; household income; highest educational attainment; health insurance; disclosure to health care provider as a gay man; reason for last healthcare visit; and, general health self-rating. The specific aims of this study were to: 1) identify general characteristics of gay men in this sample; 2) examine how levels of satisfaction with health care …

Dissecting The Impact Of Import Competition On U.S. Earnings Inequality, Felipe Benguria

Institute for the Study of Free Enterprise Working Papers

This paper studies the impact of globalization on U.S. earnings inequality in the context of rapidly growing import competition from China. The increase in U.S. inequality during 2000-2007 has been driven entirely by changes within regions}. While the existing literature has established differences in wage growth across regions as a consequence of import competition, understanding the impact of globalization on rising U.S. inequality requires then focusing on its impact on inequality within regions. Exploiting variation in exposure to this unprecedented trade shock across local labor markets I find that import competition causes an increase in earnings inequality. This impact occurs …

Increasing Inclusion: The Pursuit Of Racial Diversity In Three Historically White Universities In Kentucky, Michigan, And Ontario From 2000 To 2012, David J. Luke

Theses and Dissertations--Sociology

The University of Kentucky (UK) and University of Michigan (UM) present very different patterns in terms of black student enrollments and completions from 2000 to 2012 because of a structural explanation, a qualitative explanation, and a statistical explanation. Unfortunately, the patterns at the University of Western Ontario (UWO) are partial due to a lack of data.

First, the structural explanation is that UK, as a university in the state of Kentucky, was under a mandate from the U.S. Department of Education to desegregate because they were in violation of Title VI of the Civil Rights Act. The Kentucky Council on …

How Well Does Snap Protect Families Against The Risk Of Food Insecurity And Poor Health During Economic Downturns?, Thomas Deleire, Bradley Hardy, Jay Bhattacharya

University of Kentucky Center for Poverty Research Discussion Paper Series

Our research project addressed the question of how well SNAP and the social safety net protects families against the risk of food insecurity and poor health during economic downturns. Previous research has documented the relationship between reductions in family incomes and food insufficiency and has examined the effects of resources that mitigate the effects of income volatility. The U.S. social safety net, including SNAP, exists to mitigate the deleterious effects of swings in family income, particularly among low- and moderate-income households. This work compares outcomes for lower income families and higher income families in response to economic downturns. To the …

Using Natural Experiments To Identify The Effects Of Snap On Child And Adult Health, Daniel P. Miller, Taryn W. Morrissey

University of Kentucky Center for Poverty Research Discussion Paper Series

The Supplemental Nutrition Assistance Program (SNAP; formerly known as food stamps) can have important impacts that extend beyond its intended aims to improve food security and nutrition, particularly for health and health care use. This project examined the impact of SNAP receipt and benefit level on the health of adults and children using two natural experiments to address selection bias: 1) state policy variation in SNAP in an instrumental variables (IV) analysis; and, 2) the temporary expansion of SNAP benefits and eligibility provided through the American Recovery and Reinvestment Act (ARRA) in a difference-in-difference (DD) approach. We used restricted data …

Child Age And Gender Differences In Food Security In A Low-Income Inner-City Population, Robert A. Moffitt, David C. Ribar

University of Kentucky Center for Poverty Research Discussion Paper Series

A long literature in economics concerns itself with differential allocations of resources to different children within the family unit. In a study of approximately 1,500 very disadvantaged families with children in Boston, Chicago, and San Antonio from 1999 to 2005, significant differences in levels of food allocation, as measured by an indicator of food “insecurity,” are found across children of different ages and genders. Using answers to unique survey questions for a specific child in the family, food insecurity levels are found to be much higher among older boys and girls than among younger ones, and to be sometimes higher …

The Real Value Of Snap Benefits And Health Outcomes, Hilary W. Hoynes, Erin Bronchetti, Garret Christensen

University of Kentucky Center for Poverty Research Discussion Paper Series

The food stamp program (SNAP) is one of the most important elements of the social safety net and is the second largest anti-poverty program for children in the U.S. (only the EITC raises more children above poverty). The program varies little across states and over time, which creates challenges for quasi-experimental evaluation. Notably, SNAP benefit levels are fixed across 48 states; but local food prices vary widely, leading to substantial variation in the real value of SNAP benefits. In this study, we leverage time variation in the real value of the SNAP benefit across markets to examine the effects of …

Impact Of Food Insecurity And Snap Participation On Healthcare Utilization And Expenditures, Seth A. Berkowitz, Hilary K. Seligman, Sanjay Basu

University of Kentucky Center for Poverty Research Discussion Paper Series

We tested three hypothesis related to food insecurity and the Supplemental Nutrition Assistance Program (SNAP), America’s largest anti-food insecurity program. We hypothesized that 1)food insecurity would be associated with increased healthcare expenditures, 2)food insecurity would be associated with increased use of emergency department and inpatient services, and 3) SNAP participation would be associated with lower subsequent healthcare expenditures. We used data from the 2011 National Health Interview Survey linked to the 2012-13 Medical Expenditures Panel Survey. We used zero-inflated negative binomial regression to test the relationship between food insecurity and healthcare cost and use. We evaluated the association between SNAP …

Cultivating A Culture Of Food Justice: Impacts Of Community Based Economies On Farmers And Neighborhood Leaders In The Case Of Fresh Stop Markets In Kentucky, Heather Hyden

Theses and Dissertations--Community & Leadership Development

In this thesis, I focus on two tensions within the alternative agro-food movement. First is a question of who/what community is allowed to define food systems problems and then implement solutions. For example, food desert metaphors rely discursively on defining communities as being “without”, which perpetuates needs-based narratives, in which only professional “experts” know how to solve problems of food access. These representations ignore the creativity, agency, and resiliency of everyday food justice mobilizations happening at the grassroots level. Second, what form can solutions take within hegemonic constructions of development? I build a theoretical model based on Black geographies (McKittrick, …

The Reflection And Reification Of Racialized Language In Popular Media, Kelly E. Wright

Theses and Dissertations--Linguistics

This work highlights specific lexical items that have become racialized in specific contextual applications and tests how these words are cognitively processed. This work presents the results of a visual world (Huettig et al 2011) eye-tracking study designed to determine the perception and application of racialized (Coates 2011) adjectives. To objectively select the racialized adjectives used, I developed a corpus comprised of popular media sources, designed specifically to suit my research question. I collected publications from digital media sources such as Sports Illustrated, USA Today, and Fortune by scraping articles featuring specific search terms from their websites. This experiment seeks …

A Theory Of Veteran Identity, Travis L. Martin

Theses and Dissertations--English

More than 2.6 million troops have deployed in support of the wars in Iraq and Afghanistan. Still, surveys reveal that more than half feel “disconnected” from their civilian counterparts, and this feeling persists despite ongoing efforts, in the academy and elsewhere, to help returning veterans overcome physical and mental wounds, seek an education, and find meaningful ways to contribute to society after taking off the uniform. This dissertation argues that Iraq and Afghanistan War veterans struggle with reassimilation because they lack healthy, complete models of veteran identity to draw upon in their postwar lives, a problem they’re working through collectively …

Welfare Reform And The Intergenerational Transmission Of Dependence, Robert Paul Hartley, Carlos Lamarche, James P. Ziliak

University of Kentucky Center for Poverty Research Discussion Paper Series

We estimate the effect of welfare reform on the intergenerational transmission of welfare participation using a long panel of mother-daughter pairs over the survey period 1968-2013 in the Panel Study of Income Dynamics. Because states implemented welfare reform at different times starting in 1992, the cross-state variation over time permits us to quasi-experimentally separate out the effect of mothers’ participation on daughters’ welfare choice in the pre- and post-welfare reform periods. Our empirical framework also addresses potential issues in identifying a causal pathway from parent to child that arise from correlated unobservables in welfare decisions, misclassification error in survey reports, …

African American Female Offender's Use Of Alternative And Traditional Health Services After Re-Entry: Examining The Behavioral Model For Vulnerable Populations, Carrie B. Oser, Amanda M. Bunting, Erin L. Pullen, Danelle Stevens-Watkins

Sociology Faculty Publications

This is the first known study to use the Gelberg-Andersen Behavioral Model for Vulnerable Populations to predict African American women's use of three types of health services (alternative, hospitalization, and ambulatory) in the 18 months after release from prison. In the multivariate models, the most robust predictors of all three types of service utilization were in the vulnerable theoretical domains. Alternative health services were predicted by ethnic community membership, higher religiosity, and HIV/HCV. Hospitalizations were predicted by the lack of barriers to health care and disability. Ambulatory office visits were predicted by more experiences of gendered racism, a greater number …