Social factors shaping the adoption of lead-filtering point-of-use systems: an observational study of an MTurk sample.

Some municipalities are promoting lead-filtering point-of-use (POU) systems to minimize the risk of lead exposure through drinking water, often targeting use at racial minorities and low-income households. However, links among social inequality markers and adoption of these systems are not well understood. Survey data on adoption and use of POU systems were collected from a U.S. Mechanical Turk (MTurk) sample (N = 2,867) in March 2018. We use logistic regression to assess the association of race/ethnicity, socioeconomic status (SES), and lead-filtering POU adoption. We also examined key health behaviors related to POU systems. We found that race and SES are indirectly predictive of lead-filtering POU adoption through the propensity of some respondents to report a residence with a lead service line and levels of concern and knowledge about lead exposure. In addition, individuals with similar levels of concern about lead in water have lower odds of adopting a POU system if they have lower, rather than higher, incomes. Among POU adopters, while confidence in correct use of these devices was relatively high, the frequency of filtered water use for cooking was lower than drinking frequency. Overall, these findings inform health policies aimed at mitigating risk of lead exposure through water.

Signs of Change? At-Home and Breadwinner Parents' Housework and Child-Care Time.

We analyze American Time Use Survey (ATUS) data to examine patterns in domestic work among at-home and breadwinner parents to further gauge how time availability, relative earnings, and gender shape time use in couples with extreme differences in earnings and work hours. We find that involvement in female-typed housework is an important driver of overall housework time. It is counter-normative housework behavior by at-home fathers that shapes conclusions about how time availability, relative resources, and gender influence parents' housework. While time availability appears to shape child care in comparable ways across parents, mothers are more engaged in child care than similarly-situated fathers. Overall, our comparisons point to the importance of distinguishing among gender-normative housework tasks and accounting for differences in engagement on work and non-work days. Our results also provide a basis for assessing the social significance of growing numbers of parents in work-family roles that are not gender-normative.

The effect of advance directives on end-of-life cost experience.

PURPOSE: This study assesses the impact of Advance Directives (ADs) on end-of-life costs, drawing on administrative data from a single health care organization located in Milwaukee, Wisconsin (Independent Care Health Plan, or iCare). BACKGROUND: As part of ongoing Medicaid and Medicare rate reform efforts, greater use of ADs among plans and providers is being considered to better control costs and enhance health outcomes. APPROACH: Drawing on decedent-member descriptive and cost data, OLS regression is used to analyze the relationship between AD use and subsequent costs for a single health care plan. RESULTS: The analysis does not provide evidence of a significant relationship between AD use and end-of-life costs when patient health is controlled for the sample. CONCLUSIONS: There was no evidence within the iCare data to support a relationship between the presence of ADs and lower end-of-life costs.