6 Assessment of family disability policies
Assessment of family policy includes descriptive data on recipients (children with disability and their families), government entitlements, the costs of government entitlements, access and utilization of government benefits and services, and the impact of certain entitlements or social rights on recipients. Unfortunately, there is scarce data on families of children with disability, entitlements and issues of access, utilization and impact. In terms of cross-country comparative data, there is more descriptive information about recipients and entitlements than access, utilization and impact. The exception is comparative data on families and child disability policies published by the Organisation for Economic Co-operation and Development (OECD).1
In general, the main reason for the lack of comparative studies is that family policy often overlaps with social, health and educational policies, which makes it difficult to set exclusive methods for evaluation and assessment. The border where family policy ends and health or educational policy begins (in particular parental components) is difficult to draw. This is also the case with tax benefits or health insurances that contain regulations related to family benefits. Maternity leave policies originate from work protection legislation, and parental leave policies interfere with employment protection legislation.
Until recently, most of the family policy studies were interested in looking for implementation issues, particularly in identifying those that are not properly implemented.2 In recent years, there has been a transition from implementation-based to results-based approaches.3 However, the latter has to take into account the socioeconomic context of each country or region in setting realistic family policy strategies that assure economic, social and demographic progress.4
Sociodemographic data
Two terms that are used interchangeably in family policy research are households and families. A household is classified as either a one-person household or a multi-person household, that is, a group of two or more persons living together who make common provision for food or other essentials for living.5 The family within the household is defined as those members of the household who are related, to a specified degree, through blood, adoption or marriage. Given the complexity, it is important that information on relationship to the household head or reference person be properly processed.
The most important sociodemographic variable is the structure and type of family household. It is evident that western countries have moved toward more diversified and complex family structures. There is a significant increase in the number of one-parent families, stepfamilies, cohabiting couples, same-sex couples and children staying at home for longer periods. Sociodemographic information, which includes information about household size, shows that household size has decreased over the years. For example, the average household size in the United Kingdom fell from 2.6 persons per family to 2.4 in 2006, representing a decrease of 17 percent.6 Fertility rate is an additional important variable associated with household size. There is a significant association between women having children later in life, reduced fertility rates and the shrinking household unit. Additional sociodemographic variables are related to the economy of the household unit, and particularly to family income and wealth, labor and consumption. It is clear, as in the case of the United Kingdom, that changes in family income and wealth differ markedly according to family structure, socioeconomic status and ethnicity. While the average disposable income of individual households has increased over time, wealth has also become more unequally distributed.7 Poverty in families is probably the most central sociodemographic data and is the target of government social policy. The most common indicator in the United States is the federal poverty line,8 while in other countries there are different measures. Poverty is often linked to parental education and unemployment, as in the case of the working poor. A recent report showed that the number of working families is increasing, yet economic security remains out of reach. Between 2007 and 2011, the share of working families that are low-income – that is, below 200 percent of the official poverty threshold – increased annually and rose from 28 percent to 32 percent nationally.9 Children in poor families have worse health and educational outcomes, are more likely to experience parental divorce and more often live in single-parent families compared to children growing up in more affluent families.10
There are other sociodemographic measures associated with family policy, including cost of housing, food, transportation, childcare, and other necessities such as clothing, personal care and housing supplies. Furthermore, some reports include information about local, state and federal tax paid by families and level of dependency on social assistance and social security benefits.
Comparing family policies
Overall, assessment of family policy differs in approach and focus; it depends on the researchers’ interests and disciplines. Some approaches may also be designed to promote a particular policy model, and the selection of indicators may reflect this. In general, there are three methods of assessment and comparison of family policies: expenditures (cost), social rights or entitlements, and outcome. Assessment of expenditures or costs is probably the most common approach of data analysis used to gauge a given country’s welfare effort or to compare it with others.11
Expenditures
Comparing expenditures on certain provisions is probably one of the most common measures used in policy analysis (see the histogram presenting public expenditures on childcare and early education services, as a percentage of GDP, 2009). It is usually expressed by the average annual cost in one of the international currencies or as a percentage of GDP. Chart 6.1 demonstrates 2009 public expenditures on either childcare or early education as a percentage of GDP.12The comparison shows that Nordic countries as well as Korea lead in terms of childcare spending. Interestingly, countries such as the United Kingdom and France have followed Nordic states on preprimary expenditure.
Social rights or entitlements
While the expenditures approach is used for comparing the overall policies of countries or states, the social rights perspective aims to compare specific benefits or entitlements. It is often used in comparing childcare, parental leave regulations and cash benefits among states or countries. This type of assessment often employs indicators, capturing in summarized form the content of legal regulations in a given country. Although constructing indicators longitudinally is not an easy task, in recent years there have been efforts by the OECD as well as other international organizations to offer this perspective.13 An interesting illustration of comparing certain entitlements across countries was carried out by Center for Economic and Policy Research.14 Its report reviews the national policies of twenty-one high-income economies as of June 2008. It focuses on two key aspects of parental leave policies: the level of support provided to parents and the degree to which leave policies promote an egalitarian distribution between mothers and fathers of the time devoted to childcare.15
In terms of financial support, Sweden is the most generous of the countries examined, providing forty weeks of full-time-equivalent paid leave. The United States is one of only two countries that does not offer any paid parental leave. In terms of egalitarian distribution, the study demonstrates the use of the Gender Equality Index, measuring a country’s parental leave policy on a fifteen-point scale, with fifteen points indicating full equality of workplace and caregiving benefits to men and women. Interestingly (see Table 6.1), among the twenty-one countries surveyed, Sweden earned the highest score (13 points); while the United States rates poorly on the time and money aspects of parental leave, it fares much better on gender equality.
Table 6.1 Parental leave league Generosity of paid leave1 gender equality index2
Table notes:
1 The generosity of paid leave is measured as full-time equivalent leave: the duration of paid leave multiplied by the portion of usual wages that parents receive during that time. For example, Switzerland offers 14 weeks of leave paid at 80 percent of usual wages or the equivalent of 11.2 (rounded to 11) weeks of full-time leave.
2 The gender equality index is a scale from zero to fifteen. It incorporates the following factors: the portion of a couple’s parental leave that is reserved for, or accessible to, fathers (accounting for 9 of the 15 points); the amount of fathers’ wages that is replaced during leave available to them (accounting for 5 of the 15 points); and other incentives for fathers to participate in parental leave (plus or minus 1 point).
It is evident that while each approach has its merits, the expenditure perspective reflects the payment of transfers at a highly aggregated level only when the social rights perspective provides information at the policy level, though it cannot take into account the actual take-up of transfers or services. Neither can provide information about the impact of a certain policy on families or households.
The outcome perspective allows for the actual assessment of the impact of family policies at the household level. The most common study is examining the impact of certain policies on family trends over time. An interesting example of this type of evaluation is presented by Angela Loci and Olivier Thévenon on the impact of family policy packages on fertility trends in developed countries.16 Researchers from INED (Institut National d’Études Démographiques) in Paris examined the impact of different family policy settings on fertility using data from eighteen OECD countries spanning the years from 1982 to 2007. Using regression analysis, they found that each instrument of the family policy package (paid leave, childcare services and financial transfers) had a positive influence, suggesting that the addition of these supports for working parents in a continuum during early childhood is likely to facilitate parents’ choice to have children.
Another illustration demonstrating the importance of outcome studies was released recently (2012) by Christina Gathmann and Björn Sass.17The researchers examined whether the reform in childcare in Thuringia, Germany, had an effect on childcare choices as well as on the elasticity of labor supply with respect to childcare costs. Using data from the German Socio-Economic Panel (GSOEP), the researchers analyzed about 3,000 households from this area and demonstrated that raising prices for public childcare reduced the demand for public day care in the general population. Declines in public day-care attendance were especially dramatic for children from low-skilled, single-parent and low-income families. Interestingly, the study showed that substantial substitution occurred away from informal care by relatives, friends or neighbors to childcare in the home by parents or other household members.
The criticism is that if societal outcomes cannot be detached from societal context and social demographic circumstances, it seems often arbitrary and irrelevant to compare outcome indicators without taking into consideration the social context.
Common measures
There are common measures used in cross-national studies: composite indices, clustering by types of policies or provisions, and the representation of results in scorecards. Indices are considered handy tools that allow the collapse of a multitude of measures across countries into one dimension. The OECD-Family Policy Index was constructed in 2001 in view of the strong demand for cross-national indicators on the situation of families and children. The OECD index is probably one of the best-known in comparing family policies. A family database was developed to provide cross-national indicators on family outcomes and family policies across the OECD countries, its enhanced engagement partners and EU member states. The database brings together information from various national and international databases, both within the OECD and from external organizations. The database currently (version May 2014) includes seventy indicators under four main dimensions: (i) structure of families; (ii) labor market position of families; (iii) public policies for families and children; and (iv) child outcomes. Each indicator typically presents the data on a particular issue as well as relevant definitions and methodology, comparability and data issues, information on sources and, where relevant, includes the raw data or descriptive information across countries.
The clustering of typologies constitutes an approach of aggregation on the basis of ideological or other rationales. The most cited clustering is based on the work of Gøsta Esping-Andersen, demonstrating allocation of resources to families according to a given country’s stance on capitalism.18 A two-dimensional clustering approach was recently offered by Olivier Thévenon, showing how countries differ in the support they provide to working parents with young children and in their generosity of leave entitlements or cash transfers, and it distinguishes among five distinct groups of countries along geographical or cultural boundaries (Nordic, Anglo-Saxon, Southern European and Asian, Eastern European and Continental European).19
Finally, presenting subdimensions in scorecards does not fully aggregate indicators into one composite measure. There are approaches retaining a larger number of subdimensions but they collapse the information into qualitative categories.20 Others use graphical tools to represent the information captured in a multitude of indicators in a form that is comparable across countries and indicators.21 The latter translates a large range of indicators into standard deviations. These values are plotted on a common scale for all indicators and countries, which allows for a graphical assessment of a given country’s family policy profile.
Data sources
Since the 1980s, most governments collect and publish family policy data in a standardized form. Expenditure data is found in the OECD databases (SOCX), Eurostat (ESSPROS), and ILO (Social Security Expenditure Database). However, in family policy it is not possible to differentiate between in-cash and in-kind transfers or to separate transfers by target group or specific program.
Social rights data are collected mainly by the scientific community or university-based centers. The most well-known data is the Social Citizenship Indicator Programme (SCIP) initiated by Walter Korpi and colleagues more than thirty years ago, covering eighteen industrialized countries over a long period of time (1930–2000). However, these indicators are not yet available in the public domain. Apart from SCIP there are no other initiatives with a broad scope that collect indicators on family policy from a social rights perspective.22 One of the best investments in creating family policy databases is that undertaken by the OECD.23 The database covers a wide area of topics from different empirical perspectives, combining information on family policy expenditure with a few social rights indicators and a larger number of outcome indicators. Some of the indicators are available in longitudinal perspective. However, information on changes across time is not included in a systematic manner. Most of the indicators are taken from other databases or publications, while a few indicators are available only on the OECD Family Database.
Types of studies assessing family disability policies
Research related to family disability policies is less prevalent and probably reflects scarce interest in cross-national comparison. Most of the studies try to establish common and standard disability measures for children’s disability and characterize socioeconomic needs of their parents. In terms of policies, there are efforts made by the OECD and other international bodies to compare countries and states regarding selected entitlements or social rights, particularly with respect to their cost. The same applies to studies that assess the impact of certain policies on families of children with disability or assessing accessibility and utilization issues.
Assessment of children and social and household circumstances
Assessment of the prevalence of childhood disability and the circumstances and characteristics of children with disability is crucial to developing timely family policies and service provisions. There are certain standardized measures that are central for comparing children with disability and their families and family disability policies. The most common are type and severity of disability followed by age and gender variations. There is a growing effort in western countries to provide prevalence estimates for children with disability, but most countries, unfortunately, lack robust measures.24 The source of the problem is inconsistency in collecting up-to-date data, in particular in low-income countries. The exceptions are international initiatives such as DISTAT (the Disability Statistics Database for Microcomputers established by United Nations Statistics Division) and a functional system offered by the Washington City Group (WG). These initiatives aim to improve disability statistics in low-income countries. Similar problems are reported by the OECD with respect to proportions of severity of disability among children with disability in different countries. The assumption is that underreporting of disability is more common when this kind of information is collected through a census and not through a specialized survey, where disability benefits are not well developed or where disability is not well recognized.
There are more challenges in collecting standardized data about families of children with disability. Most of the data is based on secondary analysis of national censuses or household surveys, and it compares social and household circumstance, income and material deprivation between families with and without disability. For example, a secondary analysis of the UK Family Resources Survey (FRS) from 2004–2005 included, in addition, the number of dependent children in the family unit, housing tenure, income and material deprivation.25 Most of the studies compare families of children with or without disability by family income. An illustration for this kind of study is the analysis “Caring for children with disability in Ohio: the impact on families,” demonstrating circumstances for families caring for children with disability in that state.26 The data demonstrates that families caring for children with disability have lower incomes than families that have similar characteristics but do not care for children with disability. Similarly, OECD family data provides household socioeconomic data including poverty rates by disability status.27 It is interesting to learn the situation in the United States vis-à-vis other European countries. In the United States, the percentage of families of a child with disability living in poverty is the highest at 30.6 percent, but this is true also of those families without a child with disability at 19.5 percent (see Table 6.2). The percentage is substantially lower in France (10% compared to 8% for families of a child with disability). Interestingly, in countries such as Sweden and the United Kingdom, the percentage of families of a child with disability living in poverty is lower than in families of a child without disability (Sweden 5.4% vs. 8.0%, and in the United Kingdom 9.5% vs. 13.0%).
Comparative assessments of family policies
Interestingly, there is a lack of studies that compare family policies or entitlements related to families of children with disability across countries. A possible reason, which was discussed earlier in the chapter, is that countries tend to use different definitions and assessment mechanisms for children with disability. Some countries use specific lists of impairments with the degree of severity required for benefit entitlement. Others use level of functioning or degree of care required for a child with a disability compared to that which is needed for a nondisabled child of the same age.28 Another explanation is that countries use different social insurance programs related to an individual country’s unique history, culture and economic conditions.
Access, utilization and impact
In recent years, there have been scattered studies related to access and service utilization of children with disability and their families. Accessibility and utilization issues are often linked to financial as well as programmatic barriers.29 Most of the research touches on families that live in poverty or are recipients of social welfare services because they are better known to public administrations. There are limited studies, primarily in the United Kingdom and the United States, that have examined certain entitlements or social rights of families of children with disability. These studies are often linked to poverty reduction or to families of children with autism, severe illness or disability.
Access and utilization
The basic assumption is that families caring for children with disability struggle with employment and financial challenges that substantially reduce their access and utilization of health and family care services. Accessibility and utilization are measured by surveys and secondary analysis of national or state data.
The 2008 Ohio Family Health Survey is a typical example of the role of financial challenges on accessibility and service utilization. The survey estimated that 78,771 families (52%) caring for children with disability have difficulty paying medical bills compared to one-third (32%) of families with children without disability.30 Results from the National Survey of Children with Special Health Care Needs (NS-CSHCN 2005/06) demonstrate that 31 percent of Ohio families caring for children with disability experience financial hardship, indicating that the child’s health care caused financial problems.31 Financial hardship may be associated with having to change work schedules to meet the needs of the child. More than one-quarter (26%) have had family members cut back employment hours and nearly one-third (32%) of all families have had a family member stop working altogether to care for a child with disability.
A similar methodology to the Family Resources Survey was reported in the United Kingdom (2004/5) with 16,012 children aged zero to eighteen years.32 The findings indicated that children with disability were more likely to live with low-income, deprivation, debt and poor housing. It is understandable that this has a significant impact on accessing and utilizing health care and educational services.
Accessibility is often associated with the financial strength of each state. A recent study used secondary data from the 2005 National Survey of Children with Special Health Care Needs in combination with state characteristics to estimate the association among state residence, Medicaid reimbursement rate and problems accessing care for children with special health-care needs with and without autism.33 Findings have shown significant variation among states in the relationship between having autism and problems accessing care. The state context in which families live impacts access to care for children with autism. Moreover, when families raising children with autism live in states with higher Medicaid reimbursement rates, they are less likely to experience problems accessing care.
In general, there is less information on actual access and utilization of services of children with ASDs. As states move toward managed care approaches for their Medicaid program, services information is critical. A recent study collected behavioral health service data for children with ASDs from a state Medicaid Managed Care (MMC) program and analyzed data from fiscal years 1995 through 2000.34 Findings revealed that the number of children who received services over time increased significantly; however, the rate of service use was only one-tenth of what should be expected based on prevalence rates. The mean number of service days provided per child decreased significantly, about 40 percent, and the most prevalent forms of treatment changed. Day treatment vanished and medication and case management increased disproportionately to the number of children served.
Impact of family policy studies
The most advanced assessment is the examination of impact of certain social entitlement on children with disability and their families. There are qualitative and quantitative studies, both aimed at testing how recipients benefit from a specific provision or benefit. The qualitative approach is used in order to explore recipients’ own perspective or receive their insightful thoughts about procedures and outcome. Quantitative research is carried out on a large scale, intending to see significant changes that have occurred in families of children with disability as a result of a specific policy. Most of these studies use secondary data and tend to track changes in household measures such as household income and employment rather than children’s progress or well-being.
An example of qualitative assessment is the UK study that tested the additive value of the DLA.35 This qualitative research study, based on semi-structured interviews with twenty families that have a child or children with disability, investigated the additional costs they incur and their experiences of applying for the DLA, which is intended to cover additional disability-related costs. Although this small study has reinforced previous research findings on families’ needs and inadequate support systems, it enabled policymakers to understand in depth the impact that additional income (primarily the DLA and associated benefits) has on families’ lives. How was the additional income spent? What were families’ spending priorities? Did benefit income cover the extra costs of caring for a disabled child? What happened to families that did not claim (or were not awarded) the benefits to which their disabled children were entitled? What happened if the benefit was taken away? Interestingly, families reported that the DLA made a significant difference, not just for the child with disability but for the whole family. However, the fact that the DLA has been repeatedly down rated or withdrawn generated considerable fluctuations in income and high levels of stress and ill health. The report outlined issues that have to be addressed if the purpose of DLA entitlement is to reduce poverty amongst families of children with disability.
The most common analysis employs secondary data, trying to study the impact of certain entitlements by comparing surveys carried out in different periods. An interesting illustration is a study on the impact of child SSI enrollment on household outcomes. This analysis, taken from the survey of income and program participation between 1989 and 2005, found that the number of children receiving disability benefits from the SSI program in the United States increased from 0.26 million to 1.03 million.36 The researchers utilized longitudinal data from the Survey of Income and Program Participation (SIPP) to estimate the effect of child SSI enrollment on total household income and the separate components of income, including earnings and transfers. The data suggested that child SSI enrollment had little effect, if any, on average household earnings. Similar secondary analysis of data demonstrated that the US federal government’s program that provides cash benefits to low-income families with a disabled child has grown rapidly over the past twenty-five years. Unfortunately, this growth reflects changes in the implementation of the program rather than declines in children’s health or family income.37
Policymakers are often interested in examining the possible impact of a new policy by testing the proposed policy on recipients. A good example is Baroness Grey-Thompson’s inquiry into Disability and Universal Credit that examined whether this restructuring of support was likely to meet the government’s objectives of simplifying the system, making work pay and supporting those with the greatest needs. The inquiry was carried out in a survey of around 1,400 parents of children with disability and their families. In particular, it addressed the potential impact of a cut in support of up to £28 per week for children who are receiving any rate of DLA apart from those on the higher rate of the care component (or who are registered as blind). One of the core findings was that the impact may be greatest for single parents caring for children with disability. More than three quarters of this group said they would need to cut back on food, and two-thirds said that they would get into debt; worryingly, as many as one in six said they might need to move their household if affected by the cut. The report provides key recommendations for changes to Universal Credit to ensure that it provides fair and progressive reform to support people with disability.
Conclusion
The chapter provides the methodology and measures of assessment of family policy in general and family disability policy in particular. There are four types of assessment, including recipients’ profiles, government’s entitlements and their costs, access and utilization, and impact of certain entitlements or social rights on recipients. There is scarce data on families of children with disability, entitlements and issues of access, utilization and impact. In terms of cross-country comparative data, there is more descriptive information about recipients and entitlements than access, utilization and impact studies.
Research related to family disability policies depends on researchers’ interests and their disciplines. Some approaches may also be designed to promote a particular policy model, and the selection of indicators may reflect this. Most of the studies try to establish common and standard disability measures for children’s disability and characterize socioeconomic needs of their parents. In terms of policies, efforts have been made by the OECD, like other international bodies, to compare countries and states with respect to selected entitlements or social rights, particularly regarding their cost. The same applies to studies that assess the impact of certain policies on families of children with disability or assessing accessibility and utilization issues.
The most common comparison of cross-country family policies in the disability area is in entitlements or social rights. It is a narrative approach listing comparable programs, benefits, criteria for obtaining benefits or allowances. It provides insightful information demonstrating differences between the United States and European countries. Accessibility and utilization studies have merit as they tend to examine implementation of certain entitlements or provisions. The chapter provides examples primarily from the United States and the United Kingdom. Finally, the most advanced assessment is the examination of the impact of certain social entitlements on children with disability and their families. The chapter demonstrates qualitative and quantitative studies, primarily from the United Kingdom and the United States, aimed at testing how recipients benefit from a specific provision or benefit. The qualitative approach is used to explore recipients’ own perspectives or to receive their insights about procedures and outcome. Quantitative research is carried out on a large scale and is intended to observe significant changes that have occurred in families of children with disability as a result of a specific policy. Most of these studies use secondary data and tend to track changes in household measures, such as household income and employment, rather than children’s progress or well-being.
1 The OECD Family database was developed to provide cross-national indicators on family outcomes and family policies across the OECD countries, its enhanced engagement partners and EU member states. The database brings together information from various national and international databases, both within the OECD (see related OECD databases) and external organizations. The database currently (version December 2013) includes seventy indicators under four main dimensions: (i) structure of families; (ii) labor market position of families; (iii) public policies for families and children; and (iv) child outcomes. Each indicator typically presents the data on a particular issue as well as relevant definitions and methodology, comparability and data issues, information on sources and, where relevant, includes the raw data or descriptive information across countries. Accessed 6/9/2013 at www.oecd.org/social/family/database.
2 For further reading, see , “Helping countries build government monitoring and evaluations systems: World Bank contribution to evidence-based policymaking,” (ed.), Bridging the gap: the role of monitoring and evaluation in evidence-based policy making (Geneva: UNICEF, The World Bank and the International Development Evaluation Association, 2008), 88–97.
3 Whether and how the goals are achieved over time is assessed by Jody Zall Kusek and Ray C. Rist, “Ten steps to a results-based monitoring and evaluation system,” in Segone, Bridging the gap, pp. 98–116.
4 See Mihaela Robila, “Assessing family policies across the world: A focus on Eastern Europe” (paper for the United Nations Expert Group Meeting, “Assessing family policies: Confronting family poverty and social exclusion & ensuring work family balance” [New York: United Nations Division for Social Policy and Development, 2011]).
5 UN Statistics Division, “Principles and recommendations for population and housing censuses.” Accessed 8/1/2013 at http://unstats.un.org/unsd/demographic/sconcerns/fam/fammethods.htm.
6 The Department for Children, Schools and Families in the United Kingdom commissioned the Social Issues Research Centre at Oxford to provide an independent assessment of evidence relating to the impact of the commercial world on children’s well-being. Their report, titled “Childhood and family life: sociodemographic changes,” focuses on the engagement of families and children in the commercial world by taking a longitudinal approach to the changes and continuities in family life over the past half century. See, in particular, pp. 9–10. Accessed 8/2/2013 at http://dera.ioe.ac.uk/7413/12/Appendix-G_SIRC-report.pdf.
7 Ibid., 20.
8 Recently, the federal government introduced the new Supplemental Poverty Measure (SPM) when it comes to measuring families’ fundamental needs (CCED 2013). This new measure calculates the financial resources it takes to live free of material deprivation – that is, the cost of food, clothing, shelter and utilities – by adjusting for average expenditures on these items (and accounting for geographic differences in housing costs), as opposed to simply adjusting for overall inflation. In addition, to calculate a poverty rate, the SPM reflects the resources available to households through government policies such as tax credits and in-kind public benefit programs that affect a family’s income and, hence, their poverty status.
9 The Working Poor Families Project (WPFP) is supported by the Annie E. Casey, Ford, Joyce and Kresge Foundations, a national initiative to strengthen state policies that can assist families striving to work their way into the middle class and achieve economic security. The brief data report by Brandon Roberts, Deborah Povich and Mark Mather entitled “Low-income working families: the growing economic gap” is based on new 2011 data from the US Census Bureau’s American Community Survey, provides a snapshot of low-income working families in America and highlights the growing economic divide between working families at the top and bottom of the economic ladder. Accessed 8/2/2013 at http://www.workingpoorfamilies.org/wpcontent/uploads/2013/01/Winter-2012_2013-WPFP-Data-Brief.pdf.
10 An interesting assessment of costs is reported by Mark Mather and Dia Adams in “The risk of negative child outcomes in low-income families,” The Annie E. Casey Foundation Population Reference Bureau, April 2006. The report includes comparative assessment of the relative risks for children living in different types of families. Accessed 7/4/2012 at http://www.prb.org/pdf06/RiskNegOut_Families.pdf, p. 2.
11 See and , “Social expenditures and revenues,” et al. (eds.), The Oxford handbook of the welfare state (Oxford: Oxford University Press, 2010), 333–52. The Oxford handbook of the welfare state, the authoritative and definitive guide to the contemporary welfare state, is divided into eight sections. It opens with three chapters that evaluate the philosophical case for (and against) the welfare state. Surveys of the welfare state’s history and of the approaches taken to its study are followed by four extended sections, running to some thirty-five chapters in all, which offer a comprehensive and in-depth survey of our current state of knowledge across the whole range of issues that the welfare state embraces.
12 The OECD Family Database was developed to provide cross-national indicators on family outcomes and family policies across the OECD countries, its enhanced engagement partners and EU member states. The database brings together information from various national and international databases, both within the OECD (see related OECD databases) and external organizations. The database currently (version December 2013) includes seventy indicators under four main dimensions: (i) structure of families; (ii) labor market position of families; (iii) public policies for families and children; and (iv) child outcomes. Each indicator typically presents the data on a particular issue as well as relevant definitions and methodology, comparability and data issues, information on sources and, where relevant, includes the raw data or descriptive information across countries. OECD Family Database, “PF3.1: Public spending on childcare and early education.” Accessed 9/2/2013 at http://www.oecd.org/els/family/PF3.1%20Public%20spending%20on%20childcare%20and%20early%20education%20-%20290713.pdf.
13 OECD Family Database “CO1.9: Child disability,” pp. 10–16 provides a cross-country comparison of entitlements. The comparative tables accessed 8/8/2013 at http://www.oecd.org/els/family/CO1%209%20Child%20disability%20FINAL.pdf.
14 , and , “Who cares? Assessing generosity and gender equality in parental leave policy designs in 21 countries,” Journal of European Social Policy20 (2010), 196–216.
15 The table is presented by the Center for Economic and Policy Research, an independent, nonpartisan think tank that was established to promote democratic debate on the most important economic and social issues that affect people’s lives. CEPR’s advisory board includes Nobel laureates and economists Robert Solow and Joseph Stiglitz; Janet Gornick, professor at the CUNY Graduate Center and director of the Luxembourg Income Study; Richard Freeman, professor of economics at Harvard University; and Eileen Appelbaum, professor and director of the Center for Women and Work at Rutgers University. Accessed 6/9/2013 at http://www.cepr.net/index.php/press-releases/press-releases/european-countries-offer-more-parental-leave.
16 An interesting example of impact research is in and , The impact of family policy packages on fertility trends in developed countries, a combined report by INED (Institut National d’Études Démographiques) and , March 2011. Accessed 11/11/2013 at http://paa2011.princeton.edu/papers/111793.
17 and , Taxing childcare: effects on family labor supply and children (Bonn: Forschungsinstitut zur Zukunft der Arbeit (Institute for the Study of Labor)), IZA DP No. 6440, March 2012. Accessed 2/11/2013 at http://ftp.iza.org/dp6440.pdf.
18 , The three worlds of welfare capitalism (Princeton, NJ: Princeton University Press, 1990).
19 , “Family policies in OECD countries: a comparative analysis,” Population and Development Review37 (2011), 57–87.
20 See, for example, twofold categorization by UNICEF 2007. Accessed 4/1/2014 at http://www.unicef.org/evaldatabase/files/MICS.pdf.
21 See Henning Lohmann et al., “Towards a framework for assessing family policies in the EU,” OECD Social, Employment and Migration Working Papers, No. 88, OECD Publishing. Accessed 5/5/2013 at http://dx.doi.org/10.1787/223883627348.
22 There are additional resources that relate to single aspects of family policy. See, for example, and , “Family benefit packages,” in and (eds.) Social policy, family change and employment in comparative perspective (Cheltenham: Edward Elgar, 2006), 97–117; John Bennett, “Early childhood services in OECD countries: review of the literature and current policy in early childhood field” (Innocenti Working Paper, Florence: UNICEF Innocenti Research Centre, 2008).
23 See Willem Adema, Pauline Fron and Maxime Ladaique, “Is the European welfare state really more expensive? Indicators on social spending, 1980–2012; and a manual for the OECD Social Expenditure Database (SOCX),” OECD Social, Employment and Migration Working Papers, No. 124, OECD Publishing, 2011. Accessed 5/1/2013 at http://dx.doi.org/10.1787/5kg2d2d4pbf0-en.
24 See, for example, , Progress for children: A world fit for children, statistical review number 6, New York: UNICEF, December 2007; et al., “Definitions and measurement of chronic health conditions in childhood: a systematic review,” Journal of the American Medical Association297 (2007), 2741–51.
25 Department for Work and Pensions, “Households below average income statistics, 2004–5,” (London: Department for Work and Pensions, 2006).
26 UNICEF, Progress for children; Anthony Goudie et al., “Caring for children with disability in Ohio: the impact on families,” (white paper prepared with a grant from the Ohio Developmental Disabilities Council, New York: 2007). Accessed 8/12/2012 at http://www.ddc.ohio.gov/pub/OHFamImpStudyWhitePaper-FINAL.pdf.
27 Based on , “Directorate F: Social statistics and information society,” Unit F-3: Living conditions and social protection statistics. Comparative EU intermediate quality report, Version 3, July 2011. Accessed 8/12/2012 at http://www.oecd.org/els/family/CO1%209%20Child%20disability%20FINAL.pdf.
28 , “Social insurance provisions for children with disability in selected industrialized countries,” Social Security Bulletin58 (1995), 32–48. Accessed 8/2/2013 at http://www.ssa.gov/policy/docs/ssb/v58n3/v58n3p32.pdf.
29 et al., “Giving parents a voice: a qualitative study of the challenges experienced by parents of children with disability,” Rehabilitation Psychology55 (2010), 139–50.
30 Goudie et al., “Caring for children with disability in Ohio,” 10–11.
31 The U.S. Department of Health and Human Services, The national survey of children with special health care needs chartbook 2005–2006. Accessed 8/12/2012 at http://mchb.hrsa.gov/cshcn05/.
32 , and , “Prevalence of childhood disability and the characteristics and circumstances of disabled children in the UK: Secondary analysis of the Family Resources Survey,” BMC Pediatrics10 (2010), 21. Accessed 8/12/2012 at http://www.biomedcentral.com/1471-2431/10/21.
33 et al., “Access to care for children with autism in the context of state Medicaid reimbursement,” Maternal & Child Health Journal16 (2012), 1636–44.
34 et al., “Access and service use by children with autism spectrum disorders in Medicaid Managed Care,” Journal of Autism and Developmental Disorders35 (2005), 3–13.
35 , “Helter skelter: families, disabled children and the benefit system,” CASEpaper92 (London School of Economics, Centre for Analysis of Social Exclusion, February 2005). Accessed 8/12/2012 at http://eprints.lse.ac.uk/6272/1/Helter_Skelter_Families,_disabled_children_and_the_benefit_system.pdf.
36 Mark Duggan and Melissa Schettini Kearney, “The impact of child SSI enrollment on household outcomes: evidence from the survey of income and program participation” (NBER Working Paper No. 11568, August 2005). Accessed 9/1/2013 at http://www.brookings.edu/~/media/research/files/papers/2005/8/childrenfamilies%20kearney/200508kearney.pdf.
37 and , “The changing role of disabled children benefits,” FRBSF Economic Letter25 (September 3, 2013). Richard V. Burkhauser is a professor of policy analysis at Cornell University; Mary C. Daly is a senior vice president and associate director of research in the Economic Research Department of the Federal Reserve Bank of San Francisco. They argue that the US disability system is failing, growing at an unsustainable pace for taxpayers and delivering relatively poor outcomes to those with disability. Accessed 1/2/2014 at http://www.frbsf.org/economic-research/publications/economic-letter/2013/september/disabled-children-family-benefits-ssi-supplemental-security-income/.
