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    Broken promise of college? New educational sorting mechanisms for intergenerational association in the 21st century. Oh Byeongdon,Kim ChangHwan Social science research Previous studies have shown that intergenerational socioeconomic association becomes weaker as children's education level increases and is negligible among college graduates. A college degree is known as the great equalizer for intergenerational socioeconomic mobility. Recent studies, however, reported that the strong intergenerational association reemerges among advanced degree holders although it stays weak among BA-only holders. Despite the substantial theoretical importance and policy implications, the mechanisms behind the reemergence of the intergenerational association at the post-baccalaureate level have been less studied. In this paper, we examine the association between parents' education and children's earnings using the 2010, 2013, 2015, and 2017 National Survey of College Graduates data. Our results show that the strong intergenerational socioeconomic immobility among advanced degree holders is fully attributable to three educational sorting mechanisms: children from high-SES families (1) obtain expensive and financially rewarding advanced degrees, (2) attend selective institutions and major in hyper-lucrative fields of study such as law and medicine in graduate school, and (3) complete their education at a younger age and enjoy income growth over more years in the labor market. Implications of these findings are discussed. 10.1016/j.ssresearch.2019.102375
    Graduate Education and Social Stratification. Posselt Julie R,Grodsky Eric Annual review of sociology Graduate and professional education play an increasingly important role in economic inequality and elite formation in the United States, but sociologists have not subjected stratification in and through graduate education to the same level of scrutiny recently applied to undergraduate and sub-baccalaureate education. In this review, we discuss how prominent stratification theories might be extended to studies of the role of graduate and professional education, and we review research about stratification at junctures along student pathways into and through postbaccalaureate education to the labor market. Especially in doctoral and professional education, we find persistent stratification, including pronounced educational inheritance and disparities in participation and degree attainment by race/ethnicity and gender. We propose future directions for inquiry, highlighting unanswered questions and conceptual issues concerning how the field of and pathways through postbaccalaureate education contribute to social stratification. 10.1146/annurev-soc-081715-074324
    Validating the Use of Census Data on Education as a Measure of Socioeconomic Status in an Occupational Cohort. Cohen Sarah S,Mumma Michael T,Dupree Ellis Elizabeth,Boice John D International journal of radiation biology PURPOSE:Adjusting for smoking status or a reliable surrogate (such as socioeconomic status (SES)) is critically important in occupational epidemiology studies when any smoking-related cancer or cardiovascular disease is an outcome of interest. Sometimes, however, data on smoking patterns or individual-level smoking surrogates such as job title, education, pay scale or other measures of SES are not readily available in occupational cohorts. METHODS AND MATERIALS:To obtain a surrogate measure for missing smoking or individual-level SES data, we demonstrate a method used to obtain and geocode residential address histories which were then linked to area-level SES measures from the United States Census in 3 test samples and then in a full cohort of workers from the Mound nuclear weapons facility in Dayton, Ohio, USA. The mean educational attainment of the Census Block Group was used to derive a categorical estimate of educational attainment which was compared to self-reported education available from Mound worker histories using Kappa statistics. Lung cancer mortality patterns between area-derived (AD) and self-reported (SR) education were investigated using Standardized Mortality Ratios (SMR) and Cox Proportional Hazards models with stratification or adjustment by either SR or AD education. RESULTS:Home address histories were obtained from linkages of individual worker data to online resources. In the test cohorts, mean educational attainment was the Census Block Group measure found to have the largest magnitude association with individual-level SES measures. Among 7,251 Mound workers, 5,685 (78.4%) had at least one residential address match (mean 4.9 addresses) identified. The SR and AD educational attainment measures were highly correlated (weighted Kappa coefficient 0.10, p < 0.0001). SMR patterns by SR and AD educational attainment were similar, with steadily decreasing mortality with increased educational attainment by either measure. Cox models for lung cancer using AD education produced similar results as those using SR education as an adjustment factor. CONCLUSION:When individual-level SES indicators are not available for statistical adjustment, area-level SES measures can serve as a reliable surrogate when investigating outcomes that are affected by lifestyle factors such as smoking. 10.1080/09553002.2018.1549758
    Developing key performance indicators for prescription medication systems. Spackman Eldon,Clement Fiona,Allan G Michael,Bell Chaim M,Bjerre Lise M,Blackburn Dave F,Blais Régis,Hazlewood Glen,Klarenbach Scott,Nicolle Lindsay E,Persaud Nav,Alessi-Severini Silvia,Tierney Mike,Wijeysundera Harindra C,Manns Braden PloS one OBJECTIVE:To develop key performance indicators that evaluate the effectiveness of a prescription medication system. METHODS:A modified RAND/UCLA appropriateness method was used to develop key performance indicators (KPIs) for a prescription medication system. A broad list of potential KPIs was compiled. A multidisciplinary group composed of 21 experts rated the potential KPIs. A face-to-face meeting was held following the first rating exercise to discuss each potential KPI individually. The expert panel undertook a final rating of KPIs. The final set of KPIs were those indicators where at least 80 percent of experts rated the indicator highly i.e. rating of ≥ 7 on a scale from 1 to 9. RESULTS:292 KPIs were identified from the published literature. After removing duplicates and combining similar indicators 71 KPIs were included. The final ranking resulted in six indicators being ranked 7 or higher by 80% of the respondents and an additional seven indicators being ranked 7 or higher by ≥70 but ≤80% of respondents. The six selected indicators include four specific disease areas, measure structural and process aspects of health service delivery, and assessed three of the domains of healthcare quality: efficiency, effectiveness, and safety. CONCLUSIONS:These indicators are recommended as a starting point to assess the current performance of prescription medication systems. Consideration should be given to developing indicators in additional disease areas as well as indicators that measure the domains of timeliness and patient-centeredness. Future work should focus on the feasibility of measuring these indicators. 10.1371/journal.pone.0210794
    Does the medical insurance system really achieved the effect of poverty alleviation for the middle-aged and elderly people in China? Characteristics of vulnerable groups and failure links. Ma Meiyan,Li Ye,Wang Nianshi,Wu Qunhong,Shan Linghan,Jiao Mingli,Fu Xuelian,Li Heng,Sun Tao,Yi Bin,Tian Wanxin,Xia Qi,Shi Baoguo,Hao Yanhua,Yin Hui,Ning Ning,Gao Lijun,Liang Libo,Wang Jiahui BMC public health BACKGROUND:We examined the physiological, household, and spatial agglomeration characteristics of the health poverty population in China. We identified weak links that affect the implementation of the medical insurance and further improve its effectiveness for health poverty alleviation. METHODS:A national representative sample from the China Health and Retirement Longitudinal Study (CHARLS) was analyzed. The WHO recommended method was adopted to calculate catastrophic health expenditure (CHE) and impoverishment by medical expenses (IME). We created a binary indicator for IME as the outcome variable and applied the treatment-effect model to analyze the determinants of IME. RESULTS:The incidence of IME was 7.2% of the overall population, compared to 20.3% of the sample households trapped in CHE. The incidence of IME enrolled in insurance schemes was 7.4% higher than that of uninsured families (4.8%). Economic level, living area, family size, age of household head, having hospitalized members, and participating in insurance were statistically significant for the occurrence of IME. CONCLUSIONS:The original poverty-promoting policies has not reached the maximum point of convergence with China's current demand for health. The overlapped health vulnerabilities exacerbated the risk of poverty among the elderly and households with high health needs and utilization. In addition, the medical insurance schemes have proven to be insufficient for protection against economic burden of poor households. So, special health needs, age, and household capacity to pay should be comprehensively considered while strengthening the connection between the disease insurance scheme with supplementary insurance. 10.1186/s12889-020-08554-3