Use of a State-Level Pharmaceutical Assistance Program Among Urban and Rural Elders

A number of state-level pharmaceutical assistance programs have been established as a result of the growing recognition of the role of pharmaceuticals in the long-term care of the elderly. However, existing research does not provide a coherent expectation for patterns of use by rural and urban elderly. The data for this analysis are drawn from a larger study of the Pennsylvania Pharmaceutical Assistance Contract for the Elderly (PACE). PACE provides prescription medicines for elderly who meet income requirements. The research project was designed to assess the characteristics of PACE program participants and non-participants on a wide range of issues. Chi-square analysis and regression models were used to assess the association between rural and urban residence and access to the PACE Program. The results indicate that rural/urban status of the elderly is not a significant predictor of the use of PACE. Other traditional variables (e.g., health self-rating and physician visits) did predict difference in the pattern of use.

Men's Modesty, Religion, and the State: Spaces of Collision

This article examines religious practices in the United States, which govern modesty and other dress norms for men. I focus both on the spaces within which they most collide with regulatory regimes of the state and the legal implications of these norms, particularly for observant Muslim men. Undergirding the research are those ‘‘gender equality’’ claims made by many religious adherents, that men are required to maintain proper modesty norms just as are women. Also undergirding the research is the extensive anti-Islam bias in American culture today. The spaces within which men’s religiously proscribed dress and grooming norms are most at issue—indicated by First Amendment legal challenges to rights of religious practice—are primarily those state-controlled, total institutions Goffman describes, such as in the military and prisons. The implications of gendered modesty norms are important, as state control over religious expression in prisons, for example, is much more difficult to contest than in other spaces, although this depends entirely on who is doing the contesting and within which religious context. In American society today—and particularly within the context of growing Islamaphobia following the 9/11 attacks—the implications are greatest for those men practicing ‘‘prison Islam.’’

State Pharmaceutical Assisstance for the Elderly and Disabled: Planning Issues for Program and Non-Program States

The Medicare Catastrophic Coverage Act (MCCA) would have mandated federal assistance for Medicare beneficiaries who have high annual prescription medication costs, High national expenditures for such drugs have encouraged the development of private and state insurance programs to help with these costs. Ten state pharmaceutical assistance programs (SPAPs), designed to help certain elderly, low income, or disabled people, exist for those ineligible for Medicaid or unable to purchase coverage privately. Coordination of state and federal benefits was a consideration for established programs, and programs being planned needed to determine the feasibity of integration of federal assistance. But the enactment and subsequent appeal of the Act affected both planning and policy implications for these SPAPs. All U.S. states and territories were surveyed before the bill's repeal to collect data on the effects of MCCA for those with prescription drug programs and those without. The repeal of the federal program places pressure on the nonprogram states to proceed, perhaps more cautiously, to initiate program; for their own residents, given increasing out-of-pocket and insurance costs, and no federal program.