America's current system of health insurance, which relies almost exclusively on employer-sponsored coverage, is in danger of collapse, and this problem is not limited to the poor and working class. An increasing number of middle class Americans do not have employer-provided insurance and—due to skyrocketing premiums—cannot afford to purchase coverage for themselves. Reinsuring Health, by economist Katherine Swartz, examines this growing national crisis and outlines a concrete plan to make health insurance accessible and affordable for all Americans.

Reinsuring Health documents why the number of uninsured Americans—now 45.5 million people—has grown in the last twenty-five years. Swartz focuses on how labor market changes—such as the decline of domestic manufacturing, decreased unionization, and the growth of non-standard work arrangements—have led U.S. employers to retreat from providing health insurance for their workers. These trends, combined with the increasing costs of medical care, have led to an explosion in health insurance premiums and a decline in coverage, particularly among the middle-class. Since those who seek insurance as individuals are generally most likely to need health care, private insurers charge higher premiums in the individual (non-group) markets than to people who obtain group insurance. This makes individual health insurance less attractive to the young and increasingly unaffordable for middle-class Americans. Similarly, insurers charge higher per person (or per family) premiums to small firms than to large companies, so many small firms do not sponsor coverage for their employees. Reinsuring Health shows how these problems can be overcome if the federal government provides a new reinsurance program which would protect insurance companies that provide small group and individual health insurance against the possibility that their policy-holders will incur very high medical expenses. By assuming some of the risk that people will face extremely costly medical bills, the government will make insurers less hesitant to offer coverage to high-risk individuals, and will help drive down premiums for others. Reinsuring Health demonstrates that this form of government reinsurance has worked in the past, helping to establish smooth running private markets for catastrophe insurance and secondary mortgages.

Today, growing numbers of middle class Americans lack health insurance. Protection against the possibility of falling ill or getting hurt and having to pay extraordinary health care bills should not be a luxury available only to the very rich and the very poor. Reinsuring Health proposes a straightforward solution that would bring health insurance back within the reach of the increasing ranks of the uninsured, particularly those who are in the middle class.

KATHERINE SWARTZ is professor of health policy and management at the School of Public Health, Harvard University

This work is the fifth in a series of bulletins on the applications of sociology to various fields of professional practice prepared under the joint sponsorship of the American Sociological Association and the Russell Sage Foundation. Previous bulletins have dealt with applications of sociology in the fields of corrections, mental health, education, and military organization.

Dr. Suchman has performed an important service in his clear delineation of the great potential sociology and related disciplines have for sharpening our understanding of the social factors in health and disease, for intelligent planning and mounting of appropriate action programs, and for improving the organizational structure and institutional mechanisms of the health professions themselves.

EDWARD A. SUCHMAN is professor of sociology at the University of Pittsburgh.

Provides a directory of the rapidly expanding philanthropic foundations in Latin America, identifying over 750 foundations and presenting detailed information on 364 of them. In addition, the directory contains an introduction that analyzes historical data on Latin American foundations, a country-by-country summary of legal processes regarding foundations and pertinent tax laws, two essays by North and South American foundation presidents discussing the organization and management of private foundations, and an appendix with models of bylaws and financial statements of Latin American foundations.

ANN STROMBERG has participated in various community development projects in Latin America, taught in Latin American schools, and engaged in other sociological research projects. She is at the Pan American Development Foundation.

Unemployment among black Americans is twice that of whites. Myriad theories have been put forward to explain the persistent employment gap between blacks and whites in the U.S. Structural theorists point to factors such as employer discrimination and the decline of urban manufacturing. Other researchers argue that African-American residents living in urban neighborhoods of concentrated poverty lack social networks that can connect them to employers. Still others believe that African-American culture fosters attitudes of defeatism and resistance to work. In Lone Pursuit, sociologist Sandra Susan Smith cuts through this thicket of competing explanations to examine the actual process of job searching in depth. Lone Pursuit reveals that unemployed African Americans living in the inner city are being let down by jobholding peers and government agencies who could help them find work, but choose not to.

Lone Pursuit is a pioneering ethnographic study of the experiences of low-skilled, black urban residents in Michigan as both jobseekers and jobholders. Smith surveyed 105 African-American men and women between the ages of 20 and 40, each of whom had no more than a high school diploma. She finds that mutual distrust thwarts cooperation between jobseekers and jobholders. Jobseekers do not lack social capital per se, but are often unable to make use of the network ties they have. Most jobholders express reluctance about referring their friends and relatives for jobs, fearful of jeopardizing their own reputations with employers. Rather than finding a culture of dependency, Smith discovered that her underprivileged subjects engage in a discourse of individualism. To justify denying assistance to their friends and relatives, jobholders characterize their unemployed peers as lacking in motivation and stress the importance of individual responsibility. As a result, many jobseekers, wary of being demeaned for their needy condition, hesitate to seek referrals from their peers. In a low-skill labor market where employers rely heavily on personal referrals, this go-it-alone approach is profoundly self-defeating. In her observations of a state job center, Smith finds similar distrust and non-cooperation between jobseekers and center staff members, who assume that young black men are unwilling to make an effort to find work. As private contractors hired by the state, the job center also seeks to meet performance quotas by screening out the riskiest prospects—black male and female jobseekers who face the biggest obstacles to employment and thus need the most help.

The problem of chronic black joblessness has resisted both the concerted efforts of policymakers and the proliferation of theories offered by researchers. By examining the roots of the African-American unemployment crisis from the vantage point of the everyday job-searching experiences of the urban poor, Lone Pursuit provides a novel answer to this decades-old puzzle.

SANDRA SUSAN SMITH is assistant professor of sociology at the University of California, Berkeley.

Today, a college education is increasingly viewed as the gateway to the American Dream—a necessary prerequisite for social mobility. Yet recent policy reforms in the United States effectively steer former welfare recipients away from an education that could further their career prospects, forcing them directly into the workforce where they often find only low-paying jobs with little opportunity for growth. In Putting Poor People to Work, Kathleen Shaw, Sara Goldrick-Rab, Christopher Mazzeo, and Jerry A. Jacobs explore this troubling disconnect between the principles of “work-first” and “college for all.”

Using comprehensive interviews with government officials and sophisticated data from six states over a four year period, Putting Poor People to Work shows how recent changes in public policy have reduced the quantity and quality of education and training available to adults with low incomes. The authors analyze how two policies encouraging work—the federal welfare reform law of 1996 and the Workforce Investment Act of 1998—have made moving people off of public assistance as soon as possible, with little regard to their long-term career prospects, a government priority. Putting Poor People to Work shows that since the passage of these “work-first” laws, not only are fewer low-income individuals pursuing postsecondary education, but when they do, they are increasingly directed towards the most ineffective, short-term forms of training, rather than higher-quality college-level education. Moreover, the schools most able and ready to serve poor adults—the community colleges—are deterred by these policies from doing so.

Having a competitive, agile workforce that can compete with any in the world is a national priority. In a global economy where skills are paramount, that goal requires broad popular access to education and training. Putting Poor People to Work shows how current U.S. policy discourages poor Americans from seeking out a college education, stranding them in jobs with little potential for growth. This important new book makes a powerful argument for a shift in national priorities that would encourage the poor to embrace both work and education, rather than having to choose between the two.

KATHLEEN M. SHAW is chair of the Department of Educational Leadership and Policy Studies and associate professor of urban education at Temple University.

SARA GOLDRICK-RAB is assistant professor of educational policy studies and sociology at the University of Wisconsin-Madison, and faculty affiliate of the Wisconsin Center for the Advancement of Postsecondary Education.

CHRISTOPHER MAZZEO is a New York City–based independent consultant.

JERRY A. JACOBS is Merriam Term Professor of Sociology at the University of Pennsylvania and editor of the American Sociological Review.

An Institute for Research on Poverty Affiliated Book on Poverty and Public Policy

Classical economic theory assumes that people in risk situations follow a course of action based on a rational, consistent assessment of likely outcomes. But as Zur Shapira demonstrates in Risk Taking, corporate managers consistently stray from the prescribed path into far more subjective territory. Risk Taking offers a critical assessment of the relationship between theory and action in managerial decision making.

Shapira offers a definitive account of the classical conception of risky decision making, which derives behavioral prescriptions from a calculation of both the value and the likelihood of possible outcomes. He then demonstrates how theories in this vein have been historically at odds with empirical observations. Risk Taking reports the results of an extensive survey of seven hundred managers that probed their attitudes and beliefs about risk and examined how they had actually made decisions in the face of uncertainty. The picture that emerges is of a dynamic, flexible process in which each manager’s personal expertise and perceptions play profound roles.

Managerial strategies are continually modified to suit changing circumstances. Rather than formulating probability estimates, executives create potential scenarios based not only on the possible outcomes but also on the many arbitrary factors inherent in their own situations. As Shapira notes, risk taking propensities vary among managers, and the need to maintain control and avoid particularly dangerous results exercises a powerful influence. Shapira also examines the impact of organizational structure, long-term management objectives, and incentives on decision making.

With perceptive observations of the cognitive, emotional, and organizational dimensions of corporate decision making, Risk Taking propels the study of managerial risk behavior into new directions. This volume signals the way toward improving managerial decision making by revealing the need for more inclusive choice models that augment classical theory with vital behavioral observations.

ZUR SHAPIRA is research professor of management and organizational behavior at the Stern School of Business at New York University.

A Volume in the American Sociological Association’s Rose Series in Sociology

As the world economy becomes increasingly integrated, companies can shift production to wherever wages are lowest and unions weakest. How can workers defend their rights in an era of mobile capital? With national governments forced to compete for foreign investment by rolling back legal protections for workers, fair trade advocates are enlisting consumers to put market pressure on companies to treat their workers fairly. In Beyond the Boycott, sociologist Gay Seidman asks whether this non-governmental approach can reverse the “race to the bottom” in global labor standards.

Beyond the Boycott examines three campaigns in which activists successfully used the threat of a consumer boycott to pressure companies to accept voluntary codes of conduct and independent monitoring of  work sites. The voluntary Sullivan Code required American corporations operating in apartheid-era South Africa to improve treatment of their workers;  in India, the Rugmark inspection team provides ‘social labels’ for  handknotted carpets made without child labor; and in Guatemala,  COVERCO monitors conditions in factories producing clothing under contract for major American brands. Seidman compares these cases to explore the ingredients of successful campaigns, as well as the inherent limitations facing voluntary monitoring schemes. Despite activists’ emphasis on educating individual consumers to support ethical companies, Seidman finds that, in practice, they have been most successful when they mobilized institutions—such as universities, churches, and shareholder organizations. Moreover, although activists tend to dismiss states’ capabilities, all three cases involved governmental threats of trade sanctions against companies and countries with poor labor records. Finally, Seidman  points to an intractable difficulty of independent workplace monitoring: since consumers rarely distinguish between monitoring schemes and labels, companies can hand pick monitoring organizations, selecting those with the lowest standards for working conditions and the least aggressive inspections. Transnational consumer movements can increase the bargaining power of the global workforce, Seidman argues, but they cannot replace national governments or local campaigns to expand the meaning of citizenship.

As trade and capital move across borders in growing volume and with greater speed, civil society and human rights movements are also becoming more global. Highly original and thought-provoking, Beyond the Boycott vividly depicts the contemporary movement to humanize globalization—its present and its possible future.

GAY W. SEIDMAN is professor of sociology at the University of Wisconsin, Madison.

The Dutch economy has often been heralded for accomplishing solid employment growth within a generous welfare system. In recent years, the Netherlands has seen a rise in low-wage work and has maintained one of the lowest unemployment rates in the European Union. Low-Wage Work in the Netherlands narrows in on the causes and consequences of this new development. The authors find that the increase in low-wage work can be partly attributed to a steep rise in the number of part-time jobs and non-standard work contracts—46 percent of Dutch workers hold part-time jobs. The decline in full-time work has challenged historically powerful Dutch unions and has led to a slow but steady dismantling of many social insurance programs from 1979 onward. At the same time, there are hopeful lessons to be gleaned from the Dutch model: low-wage workers benefit from a well-developed system of income transfers, and many move on to higher paying jobs. Low-Wage Work in the Netherlands paints a nuanced picture of the Dutch economy by analyzing institutions that both support and challenge its low-wage workforce.

WIEMER SALVERDA is director of the Amsterdam Institute for Advanced Labour Studies.

MAARTEN VAN KLAVEREN is researcher and consultant at STZ Consultancy and Research.

MARC VAN DER MEER is director of studies at the Amsterdam Institute for Advanced Labour Studies.

CONTRIBUTORS: Ria Hermanussen, Robert Solow, Wim Sprenger, Kea Tijdens, Arjen Van Halem. 

A Volume in the RSF Case Studies of Job Quality in Advanced Economies

Neighborhood support groups have always played a key role in helping the poor survive, but combating poverty requires more than simply meeting the needs of day-to-day subsistence. Social Capital and Poor Communities shows the significant achievements that can be made through collective strategies, which empower the poor to become active partners in revitalizing their neighborhoods. Trust and cooperation among residents and local organizations such as churches, small businesses, and unions form the basis of social capital, which provides access to resources that would otherwise be out of reach to poor families.

Social Capital and Poor Communities examines civic initiatives that have built affordable housing, fostered small businesses, promoted neighborhood safety, and increased political participation. At the core of each initiative lie local institutions—church congregations, parent-teacher groups, tenant associations, and community improvement alliances. The contributors explore how such groups build networks of leaders and followers and how the social power they cultivate can be successfully transferred from smaller goals to broader political advocacy. For example, community-based groups often become platforms for leaders hoping to run for local office. Church-based groups and interfaith organizations can lobby for affordable housing, job training programs, and school improvement.

Social Capital and Poor Communities convincingly demonstrates why building social capital is so important in enabling the poor to seek greater access to financial resources and public services. As the contributors make clear, this task is neither automatic nor easy. The book's frank discussions of both successes and failures illustrate the pitfalls—conflicts of interest, resistance from power elites, and racial exclusion—that can threaten even the most promising initiatives. The impressive evidence in this volume offers valuable insights into how goal formation, leadership, and cooperation can be effectively cultivated, resulting in a remarkable force for change and a rich public life even for those communities mired in seemingly hopeless poverty.

SUSAN SAEGERT is professor of environmental psychology at the Graduate Center, City University of New York.

J. PHILLIP THOMPSON is Associate Professor in American politics, Columbia University.

MARK R. WARREN is associate professor in the Graduate School of Education at Harvard University.

CONTRIBUTORS:  Mark Chaves,  Cathy J. Cohen,  Cynthia M. Duncan,  Michael Foley,  Ross Gittell,  Sherman A. James,  Langley C. Keyes,  Margaret Levi,  M. Lisette Lopez,  John D. McCarthy, Lorraine C. Minnite,  Pedro A. Noguera,  Melvin L. Oliver,  Robert Putnam,  Robert J. Sampson,  Amy Schulz,  Robert Y. Shapiro,  Carol B. Stack,  Juliana van Olphen.

A Volume in the Ford Foundation Series on Asset Building

Access to capital and financial services is crucial for healthy communities.  However, many impoverished individuals and neighborhoods are routinely ignored by mainstream financial institutions.  This neglect led to the creation of community development financial institutions (CDFIs), which provide low-income communities with financial services and act as a conduit to conventional financial organizations and capital markets. Edited by Julia Sass Rubin, Financing Low-Income Communities brings together leading experts in the field to assess what we know about the challenges of bringing financial services and capital to poor communities, map out future lines of research, and propose policy reforms to make these efforts more effective.

The contributors to Financing Low-Income Communities distill research on key topics related to community development finance. Daniel Schneider and Peter Tufano examine the obstacles that make saving and asset accumulation difficult for low-income households—such as the fact that tens of millions of low-income and minority adults don’t have a bank account—and consider solutions, like making it easier for low-wage workers to enroll in 401(K) plans. Jeanne Hogarth, Jane Kolodinksy, and Marianne Hilgert review evidence showing that community-based financial education programs can be effective in changing families’ saving and budgeting patterns.  Lisa Servon proposes strategies for addressing the challenges facing the microenterprise field in the United States.  Julia Sass Rubin discusses ways community loan and venture capital funds have adapted in response to the decreased availability of funding, and considers potential sources of new capital, such as state governments and public pension funds.  Marva Williams explores the evolution and recent performance of community development banks and credit unions.  Kathleen Engel and Patricia McCoy document the proliferation of predatory lenders, who market loans at onerous interest rates to financially vulnerable families and the devastating effects of such lending on communities—from increased crime to falling home values and lower tax revenues. Rachel Bratt reviews the policies and programs used to make rental and owned housing financially accessible.  Rob Hollister proposes a framework for evaluating the contributions of community development financial institutions.

Despite the many accomplishments of CDFIs over the last four decades, changing political and economic conditions make it imperative that they adapt in order to survive.  Financing Low-Income Communities charts out new directions for public and private organizations which aim to end the financial exclusion of marginalized neighborhoods.

JULIA SASS RUBIN is assistant professor at the Edward J. Bloustein School of Planning and Public Policy at Rutgers University.

CONTRIBUTORS: Julia Sass Rubin, Rachel G. Bratt, Kathleen C. Engel, Marianne A. Hilgert, Jeanne M. Hogarth, Robinson Hollister, Jane Kolodinsky, Patricia A. McCoy, Daniel Schneider, Lisa Servon, Peter Tufano, and Marva E. Williams.