Life-Course Implications of US Public Policy

Janet M Wilmoth, Andrew S London, Janet M Wilmoth, Andrew S London

• Publisher: Routledge
• Year: 2021
• ISBN:
  9781000389524
• Edition: 1
• Topic: Derecho
• Subtopic: Derecho administrativo

There is a complex set of public policies and associated programs that constitute the social safety net in the United States. In Life-Course Implications of U.S. Public Policies, the authors encourage others to systematically consider the influence of policies and programs on lives, aging, and the life course, and how the consequences might vary by gender, race/ethnicity, sexual orientation, ability, and social class.

The volume aims to foster an appreciation of how policy influences connect and condition the life course. Chapters examine issues relating to health, housing, food security, crime, employment, and care work, amongst other issues, and demonstrate how the principles of the life-course perspective and cumulative inequality theory can be used to inform contemporary public policy debates.

Life-Course Implications of U.S. Public Policies will be a great resource for students of gerontology, sociology, demography, social work, public health and public policy, as well as policy makers, researchers in think tanks, and advocates, who are concerned with age-based policy.

1
An Introduction to Life-Course Perspectives on Public Policies

Janet M. Wilmoth and Andrew S. London

Social, economic, and health inequalities are persistent features of life in the United States. These inequalities are rooted in social structures that variably influence childhood experiences and compound (dis)advantage as individuals transition into adulthood, move through mid life, and segue to later life. The experience of inequality differs along intersecting axes of socially constructed categories, including race, ethnicity, immigrant status, class, gender, ability, and sexual orientation. Through various mechanisms, it contributes to increasing heterogeneity within birth cohorts (i.e., groups defined by specific birth years) as they age through the life course. As a result, certain groups arrive at later life with substantially fewer resources than others, which influences their capacity to cope with the challenges of aging.

Variation across cohorts in these cumulative inequality processes is produced by the unique historical experiences their members encounter at critical life stages (Ferraro, Shippee, and Schafer 2009). These historical macro-level social forces include economic cycles, demographic changes, political regimes, periods of war and peace, technological changes, pandemics, and cultural shifts.

As the modern welfare state developed in the twentieth century, the U.S. federal government increasingly developed public policies based on legislative and regulatory guidelines that were typically implemented through ground-level programs at the state and local levels. These policies and programs were designed to promote population health and well being by addressing macro-level social forces that directly and indirectly shaped life-course processes and outcomes.

An early example of this is President Franklin Roosevelt’s “New Deal,” which was implemented in the 1930s as the nation struggled to recover from the Great Depression. The New Deal was bolstered by the post-World War II economic boom, which was in part made possible by the Servicemen’s Readjustment Act of 1944 (commonly known as the “G.I. Bill”), and enhanced by the “War on Poverty” and policies enacted in response to the Civil Rights Movements of the 1960s. Together, these initiatives led to such programs as Medicare and Medicaid, as well as the expansion of a broad social safety net that aimed to level the playing field for, and promoted equality among, Americans who came of age during the middle of the twentieth century.

However, the social safety net in the United States lagged behind other welfare states. This is consequential because, as O’Rand (2003:227) notes, “more marketized societies with weaker welfare state structures provide fewer public protections against life-course risks, leading to even more heterogeneity and inequality across the lifespan.” As American politics took a neoliberal turn in the latter two decades of the twentieth century, support for some of these programs began to wane, and initiatives aimed at retrenching and reforming the welfare state were pursued (Quadagno and Street 2006). Holes began to develop in the social safety net as individual responsibility through work became an increasingly important cornerstone of eligibility for, and access to, the social safety net (Scott, London, and Gross 2007). Moreover, as the level of benefits provided decreased, the criteria for qualifying for benefits tightened and the burden of paying for these programs shifted from the federal government to increasingly strained state and local governments. As a result of these shifts, inequality in various domains has been on the rise in the United States for several decades, and the “American Dream” of financial security and upward mobility has become increasingly unattainable, particularly for younger cohorts (Chetty et al. 2017).

One life-course manifestation of this phenomenon is the delay in achieving the traditional markers of adulthood that recent cohorts are experiencing, as encapsulated by the new transition to adulthood framework (Settersten and Ray 2010). The current COVID-19 pandemic is making the transition to adulthood even more fraught for the millennial cohort (Settersten et al. 2020). In addition, there is mounting evidence that the pandemic is exacerbating inequalities, as local, state, and federal governments have failed to mount an effective, coordinated policy response, while tax revenues that support social programs are shrinking due to the contraction of the economy. The pandemic has disrupted lives across the board, but certain segments of the population, including older adults, poor and working-class families, women, people of color, individuals with disabilities, and institutionalized individuals are particularly at risk of contracting the disease and experiencing its social, economic, cultural, and psychological consequences (Settersten et al. 2020).

Given this state of affairs, it is crucial that life-course scholars have a firm understanding of how public policies and their associated social programs shape cumulative inequality within and between cohorts. In addition, policy makers need to appreciate how their decisions directly and indirectly impact various life course outcomes. Therefore, in this introductory chapter, we aim to set the stage for the chapters that follow by providing an overview of the social safety net in the United States and discussing how the core principles of the life-course perspective can be used to understand the short and long term implications of public policies. We conclude the chapter with a brief introduction to each of the chapters included in this volume, which individually and collectively address the life-course consequences of specific but interrelated policies and programs.

The Social Safety Net in the United States

The social safety net comprises various programs that offer in-kind aid and cash transfers to individuals and families. The goal of these programs is to provide assistance in times of need and protection against life’s uncertainties. These programs also are designed to promote population health and well-being. Countries (and states or regions within countries) with stronger social safety nets have higher life expectancies, fewer health disparities, and less economic inequality (Avendano and Kawachi 2014; Bor, Cohen, and Galea 2017). The strength of the social safety net in any given country depends on the legislative and regulatory policies that govern—and the budgetary priorities that support—the implementation of specific social programs.

As shown in Table 1.1, the U.S. social safety net is made up of a patchwork of policies and associated programs that are: administered by federal, state, and local governments; supplemented by employer-provided benefits; and supported by a progressive tax code. While it is beyond the scope of this brief chapter for us to discuss each of these in detail, here we highlight some basic features of key programs and provide some evidence about their use.

Table 1.1 Social safety net in the United States

Type of program	For more information, go to:
Social assistance (aka “welfare”):
• Temporary Assistance for Needy Families (TANF)	https://www.acf.hhs.gov/ofa/programs/tanf/about
• Supplemental Nutrition Assistance Program (SNAP)	https://www.fns.usda.gov/snap/supplemental-nutrition-assistance-program
• Women, Infants, and Children (WIC)	https://www.fns.usda.gov/wic
• Child Nutrition	https://www.fns.usda.gov/cn
• Medicaid	https://www.medicaid.gov/
• Supplemental Security Income (SSI)	https://www.ssa.gov/ssi/
• Housing Assistance	https://www.hud.gov/topics/rental_assistance
• Low Income Home Energy Assistance Program	https://www.acf.hhs.gov/ocs/programs/liheap
• Head Start	https://www.acf.hhs.gov/ohs
• Pell Grants	https://studentaid.gov/understand-aid/types/grants/pell
• Job Training	https://www.dol.gov/general/topic/training/adulttraining
• Lifeline	https://www.fcc.gov/consumers/guides/lifeline-support-affordable-communications
Social insurance (aka “entitlement” programs):
• Social Security	https://www.ssa.gov/
• Retirement Benefits	https://www.ssa.gov/benefits/retirement/
• Disability Benefits	https://www.ssa.gov/benefits/disability/
• Medicare	https://www.ssa.gov/benefits/medicare/
• Unemployment Insurance	https://www.dol.gov/general/topic/unemployment-insurance
Tax code:
• Child Tax Credit	https://www.irs.gov/taxtopics/tc602
• Child and Dependent Care Credit	https://www.irs.gov/taxtopics/tc602
• Earned Income Tax Credit	https://www.irs.gov/credits-deductions/individuals/earned-income-tax-credit
• Home Mortgage Interest Deduction	https://www.irs.gov/pub/irs-pdf/p936.pdf
• Medical Expenses deductions	https://www.irs.gov/taxtopics/tc502
Employment-based benefits:
• Private Pension Programs	https://www.usa.gov/retirement
• Health Insurance	https://www.ncbi.nlm.nih.gov/books/NBK235989/
• Supplemental Benefits (Vision, Dental, Disability, Life Insurance) & Paid Leave	https://center-forward.org/working-nine-to-five-the-u-s-and-employer-sponsored-benefits/
• Family and Medical Leave	https://www.dol.gov/general/topic/workhours/fmla
• Childcare and Medical Flexible Savings Accounts	https://www.fsafeds.com/

Social assistance programs (also known as “welfare”) and social insurance programs (also known as “entitlement”) are the foundation of the U.S. social safety net. Social assistance programs that rely on means-testing provide a range of services targeted to individuals and families who meet specific income- and asset-eligibility criteria. They offer income, health care, nutritional, housing, educational, and employment support to those who are most in need. Approximately 21% of the population uses at least one of five major assistance programs. The most commonly used programs are Medicaid (15%) and the Supplemental Nutrition Assistance Program (SNAP) (13%), whereas a very small percentage of the population uses housing assistance (4%), Supplemental Security Income (SSI) (3%), and Temporary Assistance for Needy Families (TANF)/General Assistance (GA) (1%) (U.S. Census Bureau 2015a). In addition, most program participation is episodic and short-term. The length of participation is 12 months or less for nearly one-quarter of housing assistance recipients; about one-third of Medicaid, SNAP, and SSI recipients; and about two-thirds of TANF/GA recipients (U.S. Census Bureau 2015b). Children under the age of six years old whose families have incomes below the federal poverty threshold are eligible for Head Start educational programs, which serve over one million children annually (Early Childhood Learning & Knowledge Center 2020). In addition, Healthy Start programs, which offer individual- and community-level services that promote child health, are available in over 100 communities with high infant mortality rates in 37 states and the District of Columbia (Escarne et al. 2017). Low-income adults with demonstrated financial need might be eligible for the Federal Pell Grant Program, which pays for postsecondary education. In 2017–2018, there were over 7.1 million Pell Grant recipients, with an average award of $4,031 (U.S. Department of Education 2020). These parental, early-childhood, and early adulthood programs might contribute to decreased use of social safety net programs later in life given the importance of education to a range of socioeconomic and health outcomes over the life course.

In contrast to social assistance programs, social insurance programs are broadly available to all individuals. The specific criteria that define the access threshold are typically based on work-related credits, contributions to the program over the life course, age, specific medical conditions, and/or being the spouse or child of an eligible individual. Social insurance programs are designed to address needs associated with unemployment, retirement, illness, and disability. Although the unemployment rate had dropped to historically low levels prior to the advent of the COVID-19 pandemic in early 2020, the percentage of the unemployed who receive benefits has been relatively constant. Between 2010 and 2019, the unemployment rate dropped from 10% to 3.5% (U.S. Bureau of Labor Statistics 2020), but the unemployment insurance recipiency rate was consistently less than 30% (U.S. Department of Labor 2019). Nearly 20% of people in the United States receive Social Security benefits as retired workers, disabled workers, or spouses and dependent children of retired, disabled, or deceased workers. Almost 90% of adults aged 65 and older receive Social Security benefits, which are the single largest source of income for a majority of these older adults (U.S. Social Security Administration 2020; see also Street and Ní Léime in this volume). While almost all adults over the age of 65 receive Medicare, some older adult immigrants fall through the cracks and are uninsured due to conflicting priorities at the nexus of immigration and health care policies (Stewart and London 2015).

Given that U.S. social programs are not as extensive or generous as other welfare states (see Harrington Meyer and Kandic in this volume), employment based bene...