Cross-State Differences in the Processes Generating Black-White Disparities in Neonatal Mortality.

The U.S. Black neonatal mortality rate is more than twice the White rate. This dramatic disparity can be decomposed into two components: (1) disparities due to differences in the distribution of birth weights, and (2) disparities due to differences in birth weight-specific mortality. I utilize this distinction to explore how the social context into which infants are born contributes to gaps in mortality between Black and White neonates. I analyze variation in Black-White differences in neonatal mortality across 33 states using 1995-2010 data. For each state, I calculate the contribution of differences in birth weight distribution versus differences in birth weight-specific mortality to the total disparity in mortality between White and Black neonates. Disparities are largely a product of different birth weight distributions between Black and White newborns (mirroring the pattern for the United States as a whole). However, in at least nine states, differences in birth weight-specific mortality make a notable contribution. This pattern is observed even among those from advantaged sociodemographic backgrounds and is driven by differences in mortality among very low birth weight neonates. This calls attention to inequality in medical care at birth as an importantcontributor to racial disparities in neonatal mortality.

Trading Equality for Health? Evaluating the Trade-off and Institutional Hypotheses on Health Inequalities in the Global South.

It has been suggested that as medicine advances and mortality declines, socioeconomic disparities in health outcomes will grow. Yet, most research on this topic uses data from affluent Western democracies, where mortality is declining in small increments. We argue that the Global South represents the ideal setting to study this issue in a context of rapid mortality decline. We evaluate two competing hypotheses: (1) there is a trade-off between population health and health inequality such that reductions in under-five mortality are linked to higher levels of social inequality in health; and (2) institutional interventions that improve under-five mortality, like the expansion of educational systems and public health expenditure, are associated with reductions in inequalities. We test these hypotheses using data on 1,369,050 births in 34 low-income countries in the Demographic and Health Surveys from 1995 to 2012. The results show little evidence of a health-for-equality trade-off and instead support the institutional hypothesis.

Trends in Income Insecurity Among U.S. Children, 1984-2010.

Has income insecurity increased among U.S. children with the emergence of an employment-based safety net and the polarization of labor markets and family structure? We study the trend in insecurity from 1984-2010 by analyzing fluctuations in children's monthly family incomes in the Survey of Income and Program Participation. Going beyond earlier research on income volatility, we examine income insecurity more directly by analyzing income gains and losses separately and by relating them to changes in family composition and employment. The analysis provides new evidence of increased income insecurity by showing that large income losses increased more than large income gains for low-income children. Nearly one-half the increase in extreme income losses is related to trends in single parenthood and parental employment. Large income losses proliferated with the increased incidence of very low incomes (less than $150 per month). Extreme income losses and very low monthly incomes became more common particularly for U.S. children of nonworking single parents from the mid-1990s.

Healthcare Systems in Comparative Perspective: Classification, Convergence, Institutions, Inequalities, and Five Missed Turns.

This essay reviews and evaluates recent comparative social science scholarship on healthcare systems. We focus on four of the strongest themes in current research: (1) the development of typologies of healthcare systems, (2) assessment of convergence among healthcare systems, (3) problematization of the shifting boundaries of healthcare systems, and (4) the relationship between healthcare systems and social inequalities. Our discussion seeks to highlight the central debates that animate current scholarship and identify unresolved questions and new opportunities for research. We also identify five currents in contemporary sociology that have not been incorporated as deeply as they might into research on healthcare systems. These five "missed turns" include an emphasis on social relations, culture, postnational theory, institutions, and causal mechanisms. We conclude by highlighting some key challenges for comparative research on healthcare systems.