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BACKGROUND: Preliminary evidence suggests that sexual minority (e.g. lesbian, gay, bisexual, and same-sex attracted) youth are overrepresented in child welfare services. Yet, no study to date has been able to test this hypothesis with national data. OBJECTIVE: Using a two-study design, we test whether sexual minority youth are overrepresented in child welfare, foster care, and out-of-home placement using nationally representative data from the United States. PARTICIPANTS AND SETTING: Study 1 data are from the National Longitudinal Study of Adolescent to Adult Health (n = 14,154; Mean age = 15.4). Study 2 data are from wave three of the National Survey of Child and Adolescent Well-Being II (n = 1309; Mean age = 15.0). METHODS: For Study 1, we use adjusted logistic regression models to test differences in lifetime foster care involvement between sexual minority and heterosexual youth. In Study 2, we calculate a Disproportionality Representation Index (DRI) - a ratio of sample prevalence relative to the general population - to estimate whether sexual minority youth were overrepresented in child welfare and out-of-home care. RESULTS: Study 1 results indicate that sexual minority youth are nearly 2.5 times as likely as heterosexual youth to experience foster care placement (aOR = 2.43, 95% CI 1.40, 4.21, p = .002). Results from Study 2 show that sexual minority youth were largely overrepresented in child welfare services (DRI = 1.95-2.48) and out-of-home placement (DRI = 3.69-4.68). CONCLUSIONS: Findings are the first to demonstrate sexual minority youth's overrepresentation in child welfare, foster care, and out-of-home placement using nationally representative data and emphasizes the need for focused research on sexual minority youth involved in the child welfare system.

This paper investigates the labor market returns to high school types. We exploit comprehensive administrative data describing the school-to-work transition for the universe of Chilean students attending tenth grade in 2001. We discuss the role of self-selection into school types, pre-labor market abilities, firm characteristics, and present bounds for the parameters of interest. Attending private high schools has long-lasting e ects on earnings. Moreover, the long-term returns to school-level valueadded measures and monetary investments in education are larger among private-school students. Our findings provide new insights into the association of school choice and the inertia of income inequality.

Objectives: I extend the life-course theory of cumulative disadvantage to focus on continuity in punishment across generations. Specifically, I examine (1) the association between paternal incarceration and elementary school suspension or expulsion and (2) the extent to which behavior problems and weakened social bonds explain this association. Method: Analyses rely on logistic regression, propensity score matching, and mediation methods with data from the Fragile Families and Child Wellbeing Study (N = 3,201), a birth cohort of children born in large U.S. cities between 1998 and 2000. Results: The odds of school punishment among children who had a residential father incarcerated by age 5 are 75 percent greater than the odds for children in a matched control group. About one third of this association is accounted for by behavior problems and weakened social bonds. Even after accounting for behavior problems and social bonds, children whose fathers were incarcerated are at greater risk of school punishment. Conclusions: I find evidence of an intergenerational stability of punishment and mixed support for an intergenerational extension to cumulative disadvantage theory. Paternal incarceration is associated with children’s likelihood of experiencing formal punishment in elementary school, and behavior problems and weakened social bonds explain part of this association

Deferred Action for Childhood Arrivals (DACA) recipients face an uncertain fate as their future in the United States is being debated. Yet even before the program was introduced in June 2012 and became endangered in September 2017, they encountered challenges in navigating a fragmented health care landscape throughout the United States. This paper focuses on  DACA  recipients' experiences in accessing health care throughout their lives, both before and after receiving DACA. We conducted semi-structured interviews and questionnaires with 30 DACA recipients living in Maryland between April–December 2016. Participants represented 13 countries of origin and ranged in age between 18 and 28. Results demonstrate that DACA recipients have had punctuated coverage throughout their lives and continue to face constrained access despite temporary gains in status. Health care access is further stratified within their mixed-status families. Participants have also experienced shifts in their health care coverage due to moving between jurisdictions with variable eligibility and changing life circumstances related to family, school, and employment. This article underscores the importance of examining young adult immigrants' access to care over time as they weather changes in the broader policy context and in highly variable contexts of reception nationwide, shaped by state, but also county and city policies and programs. The challenges and gaps in coverage DACA recipients face also underscore the need for both health care and immigration reform.

People rely on their experiences when making important decisions. In making these decisions, individuals may be significantly influenced by the timing of their experiences. Using administrative data, we study whether the order in which students are assigned courses affects the choice of college major. We use a natural experiment at the United States Military Academy in which students are randomly assigned to certain courses either during or after the semester in which they are required to select their college major. We find that when students are assigned to a course in the same semester as they select a major, they are over 100 percent more likely to choose a major that corresponds to that course. Despite low switching costs, approximately half of the effect persists through graduation. Our results demonstrate that the timing of when students are assigned courses has a large and persistent effect on college major choice. We explore several potential mechanisms for these results and find that students’ initial major choice best fits a framework we develop that incorporates salience and availability. Furthermore, our results suggest that once students select a major, they are less likely to switch majors than the standard model of economic choice predicts. Instead, students’ decision to remain in a major is more consistent with status quo bias.

  Background Europe is becoming more social and cultural diverse as a result of the increasing migration, but the medical doctors are largely unprepared. The medical education programmes and teachers have not evolved in line with development of the population. Culturally competent curricula and teachers are needed, to ensure cultural competence among medical doctors and to tackle inequalities in health between different ethnic groups. The objective of this EU financed study is therefore to provide a snapshot of the role of cultural competence in European medical educational programmes. Methods A questionnaire was developed in order to uncover strengths and weaknesses regarding cultural competence in the European medical education programmes. The questionnaire consisted of 32 questions. All questions had an evidence box to support the informants’ understanding of the questions. The questionnaire was sent by email to the 12 European project partners. 12 completed questionnaires were returned. Results Though over half of the participating medical programmes have incorporated how to handle social determinants of health in the curriculum most are lacking focus on how medical professionals’ own norms and implicit attitudes may affect health care provision as well as abilities to work effectively with an interpreter. Almost none of the participating medical programmes evaluate the students on cultural competence learning outcomes. Most medical schools participating in the survey do not offer cultural competence training for teachers, and resources spent on initiatives related to cultural competences are few. Most of the participating medical programmes acknowledge that the training given to the medical students is not adequate for future jobs in the health care service in their respective country regarding cultural competence. Conclusions Our results indicate that there are major deficiencies in the commitment and practice within the participating educational programs and there are clear potentials for major improvements regarding cultural competence in programmes. Key challenges include making lasting changes to the curriculum and motivating and engaging stakeholders (teachers, management etc.) within the organisation to promote and allocate resources to cultural competence training for teachers.

Principal Investigator Jie Chen, with Andrew Fenelon and others, was awarded a grant to study care coordination on ethnic minority populations

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