Increasing understanding of the factors influencing access ... · Increasing understanding of the...
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IncreasingunderstandingofthefactorsinfluencingaccesstoandutilizationofservicesamongJewishindividualsandfamilieslivinginpovertyintheSt.Louisarea
AreporttotheJewishFederationofSt.Louis
October,2018
ElizabethA.Baker,PhD,MPHKeonL.Gilbert,DrPH,MA,MPA
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ExecutiveSummary
In-depthindividualinterviewsandsurveyswereconductedwithserviceproviders(19)andindividuals/familiesintheJewishCommunitywhohaveusedservices(10).Providersindicatedthatthefourfactorsthatmayinfluenceconsumers’useofservicesarecost,stigma,familyobligationsandtransportation.Theyalsoindicatedthatthatfood,mentalhealthandchild-careserviceswerethemostutilizedservices.Eldercareserviceswereamongthosethatweretheleastutilized.Servicesthatprovidersindicatedwerethemostwell-fundedwerecontinuingeducation,foodandmentalhealthservices.Housingrepair,substanceuse,andhousingaccesswereidentifiedastheleastwell-funded.Providersalsoindicatedthatwhileallservicescouldbenefitfromadditionalfundingandresourceallocation,food,eldercare,childcare,employment,andmentalhealthservicesweremostinneedofadditionalfunding.Oftheservicesweaskedprovidersabout,employment,childcare,housingrepair,mentalhealth,foodandhealthcareserviceswerementionedasbeingamongthegreatestneeds.Someprovidersalsoindicatedthatthereweresomeotherneedsthatcouldbeaddressedforyouthsuchasorthodontics,music,art,dance,andsports.Theaverageageofconsumerswhocompletedthequestionnairewas53,witharangeofagesbetween42and73.Fiftypercentofparticipantsdescribedthemselvesas“unabletomakeendsmeet,”andtheremaininghalfofparticipantsdescribedtheirhouseholdfinancialsituationas“justmanagingtomakeendsmeet.”Theparticipantswereprimarilyfemale(87.5%).Intermsofeducation,themajorityofparticipantshadanAssociatedegreeorsomecollegeexperience(66.67%).Themajorityofparticipantswerereform(62.5%)withallother“denominations”beingrepresentedby12.5%ofrespondents(orthodox,conservative,non-denominationaland“JustJewish”).Themajority(75%)ofparticipantsindicatedthatbeingJewishwasveryorsomewhatimportanttothem.WhilethissampledoesnotrepresentthecompletediversityoftheJewishpopulationexperiencingpovertyintheSt.Louisarea,thequalitativeandquantitativedataprovideddoessuggestsomeconsistentconcernsandpresentsomecompellingopportunitiesforimprovingservicestoenhanceaccessandutilization. Fiftypercentormoreofconsumersindicatedthatthefollowingwerealways,often,orsometimesafactorinfluencingutilizationofservices:cost,stigma,agencyisJewishaffiliated,healthstatusandtransportation.Whenaskedabouthowlikelytheyweretouseavarietyofservices,overathirdoftheconsumersindicatedthattheywereverylikelytousethefollowing:housingrepair,employment,continuingeducation,mentalhealth,foodandhealthcare.Itshouldbenotedthattheneedforsomeservicesmayhavebeendifferentinoursamplethantheoverallpopulationinneedbecauseofavarietyoffactorssuchasagedistributionorchildreninthehousehold.
Thequalitativeinterviewswithbothprovidersandconsumersidentifiedanumberoffactorsthatwereidentifiedasinfluencingaccesstoandutilizationofservicesattheindividual,social/cultural,organizational,interorganizationalandenvironmental/contextuallevels.
Intermsofindividuallevelfactorsthoseinterviewedindicatedthatthereisalackofinformationaboutservicesprovidedandtheeligibilityrequirementsforusingtheservices.Theyalsoindicatedthattherewasagreatdealofbureaucracyinaccessingservices.Respondentsalsoindicatedthatconsumersoftendo
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notwanttosharepersonalinformation.Therewereconcernsraisedaboutstigmaimposedbystructuresandindividualsandembarrassmentregardinguseofservicesaswellasfearaboutwhathappensiftheiruseofservicesisdiscoveredbyothers.Therewereconcernsraisedaboutstigmathattheyidentifiedasbeingcreatedbythestructuresofaccessingcarenotonlyafunctionofindividualbeliefs.
Intermsofsocial/culturalfactors,concernswereexpressedthatsomeprovidersmaynotbesensitivetotheuniqueneedsofJewishfamiliesandsomearticulatedalackofunderstandingofthedifferentneedsamongdenominationswithintheJewishcommunity.ThoseinterviewedalsoexpressedconcernsthatparticipatinginJewishcommunallifeisexpensive,puttingfamiliesinapositionwheretheyneedtorequestassistancebutdonotmeetmosteligibilityrequirementsforservices.Itwasalsonotedthattheimportanceofthereligiousaffiliationoftheserviceagencyorspecificprovidervariesconsiderablyandtoalargeextentdependsonthetypesofservicesneeded.Inotherwords,religiousaffiliationislikelytomattermoreforthingslikefoodandmentalhealth,andlessforthingslikehousingandcarrepair.
Intermsoforganizationalfactors,thoseinterviewedvoicedconcernsaboutunclearcriteriaforutilizationofservices,aswellasbureaucracyandrestrictionsonhowresourcescanbeused.Thoseinterviewedalsopointedtoconcernsaboutinsufficientservices,inconvenienthoursofservice,limitedlocationsandservicemodels.TherewerealsoconcernsthattheservicesprovidedwithintheJewishcommunityareinferior.Inpart,thiswasattributedtostaffturnover,andstaffnotknowingaboutserviceswithintheirownagencies.
Intermsofinterorganizationalfactors,thoseinterviewednotedthatJewishagenciesoftendon’treferindividualsorfamiliestoeachother.Thiswasidentifiedasbeinginpartduetothefactthattheyareunawareofwhatotherorganizationsoffer.Theyalsonotedthesignificantproblemscausedbyinteragencysilos.Inparticularthoseinterviewedvoicedtheneedforinteragencyagreementstoeasetheuseofservices,andthesharingofcaseinformationtoreducetheburdenonfamilies. TheyalsohighlightedtheneedforJewishandnon-Jewishagenciestocreatewaystoshareinformationaboutservicesandworkmorecollaboratively.
Inconsideringcontextualfactors,theoneissuethatwasnotedrepeatedlywaschallengeswithtransportation.Thoseinterviewedalsonotedthatthereisageneralneedforadditionalservices,particularlymentalhealthservices,homeimprovement,andnecessitiesbeyondfood(e.g.,toiletpaper,toothpaste).
Basedonourfindings,thereisnotonesinglebestapproachforimprovingservicestoJewishindividualsandfamilieslivinginpovertyintheSt.Louisarea.Ratherthemostimportantchangesmaybedifferentdependingonthecircumstance,theindividual,andtheirdenomination.However,bothprovidersandconsumershadsomekey,andconsistent,recommendations.Someoftheserecommendationsarethedirectextensionofchallengesthatwerehighlighted(e.g.,peopledon’tknowaboutservices),whileothersarestrategiesidentifiedbythoseinterviewed(e.g.,tellpeopleinthecommunityaboutservicesthroughprintmedia,socialmedia,orinperson).Morespecifically,thedatasuggestthatinordertoimproveaccesstoandutilizationofservicestheFederationneedsto1)improvemarketing/communicationtoincreaseawarenessofandinformationaboutservices,2)establishformalnetworksandcollaborationamongserviceproviders,3)createopportunitiesforprovidingon-going,confidentialfeedbackonhowtoimproveservices,and4)createalternativeserviceprovisionmodels.
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TableofContents
Background Page5
PuttingtheexperienceofpovertywithinSt.Louisintoalocalandnationalcontext
Page6
Factorsinfluencingaccesstoandutilizationofservices
Page10
OpportunitiesforactionandreflectionAppendix:Surveyinstruments
Page19Page22
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Background
OneoftheJewishFederation’sgreatestprioritiesistobuildahumanservicesafetynettoidentify,monitor,andcareforthemostvulnerableandisolatedmembersoftheJewishcommunity.In2014theFederationconductedastudythatfoundthatpovertyandhungerintheJewishcommunitywashigherthananticipated,with26%oftheJewishcommunityintheSt.Louisareaconsideredpoorornearpoor.Thestudyalsofoundseveralbarrierstoserviceutilizationamongthispopulation.TheirsubsequentPovertySummitinFebruaryof2016foundthatthereweremanygapstoservicesincluding:
• Lackofknowledgeaboutbenefitsandresourcesaswellasaccesschallenges–individualsdonotknowwhatprogramsareavailablefromtheJewish,publicandsecularorganizations,andmayneedassistancecompletingcomplicatedapplicationprocesses.
• Multiplepointsofentrywithlittlecoordination–thereisnocommoninformation,intake,andreferralsystemtoaccessavailableresources.Peopleinneedhavetoseekassistanceseparatelyfromnumerousorganizations,eachwithdifferingrequirementsandapplicationrequirements.
• Needforvocationalretrainingandotheremploymentprograms–individuals,especiallyBaby
Boomers,havelostjobsorbusinessesandneedhelptoidentifyandpursuealternatecareerpaths.
• Perceivedstigmaofaskingforhelp–individualsintheJewishcommunityarenotusedtoasking
forhelpandfeelembarrassedorashamed,especiallyiftheyconsiderthemselvestobedonorstocharitablecausesandnotrecipientsofhelp.
Thisreportpresentsthefindingsfromastudythatbuiltontheseinitialfindings.Thestudywasconductedinthefallof2016andwinterof2017andsoughtto:
• situatetheexperienceofpovertywithinSt.Louisintoalocalandnationalcontext,• enhanceunderstandingoffactorsinfluencingaccesstoandutilizationofservices,and• developsuggestionsforspecificchangestoimprovetheservicesofferedtoJewishindividuals
andfamilieslivinginpovertyintheSt.Louisarea.
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SituatingtheexperienceofpovertywithinSt.Louisintoalocalandnationalcontext
MethodsInordertodescribepovertyintheJewishcommunity,bothlocallyandnationally,werevieweddatafromtheBermanJewishDatabank(aprojectoftheJewishFederationsofNorthAmerica,http://www.jewishdatabank.org),publishedreports,1andhaddiscussionswithJewishFederationsinothercities.BelowweprovideinformationonthedemographicandgeographicdistributionoftheJewishpoor.Wesynthesizethefindingsfromlocal,STLbasedassessmentswithassessmentsconductedbyotherJewishorganizationsincludingthoseinChicago,IL;Cincinnati,OH;Cleveland,OH;andNewYork,NY.
Results
BasedondatafromBermanJewishDatabankthenumberofJewsinMissourideclinedfrom1971(84,325)to2015(64,275)(http://www.jewishdatabank.org),withSt.LouisbeingtheonlyurbanareainMissouriwithmorethan40,000Jews(54,000).2ForcomparisonsakeitisworthnotingthesizeoftheJewishpopulationineachofthecomparisoncommunities(definedasJewishPopulationoftheJewishFederationServiceareaorCombinedStatisticalAreadependingondataavailablein2015):Chicago,IL291,800;Cincinnati,OH;Cleveland,OH85,653;andNewYork,NY1,538,0003.
1JewishPolicy&ActionResearch.2014StLouisJewishCommunityStudy.2014StLouisJewishCommunityStudy.HumanServices:Poverty,Hunger,SocialServicesandSeniors.PresentedApril20,2015.JewishFederationofStLouis.PovertySummitNotes.February10,2016Ukeles,JB(2012)Ataleoffourcities:LearningaboutJewishCommunity.Presentationpresentedatthe2012GeneralAssemblyinBaltiore,MD.2IraM.SheskinandArnoldDashefsky.“JewishPopulationintheUnitedStates,2015,”inArnoldDashefskyandIraM.Sheskin.(Editors)TheAmericanJewishYearBook,2015,Volume115(2015)(Dordrecht:Springer)pp.163-260.
3IraM.SheskinandArnoldDashefsky.“JewishPopulationintheUnitedStates,2015,”inArnoldDashefskyandIraM.Sheskin.(Editors)TheAmericanJewishYearBook,2015,Volume115(2015)(Dordrecht:Springer)pp.163-260.
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AsisevidentinTables1-3,below,thesurveysconductedineachofthesecitiesusedsomewhatdifferentsamplingmethods(e.g.,randomdigitdialingversussamplingbasedonlastname),anddefinedthevariablesintheirsurveysomewhatdifferently(e.g.,100%federalpovertyversus150%federalpoverty).Inspiteofthis,therearesomeusefulcomparisons.Forexample,inallcommunitiesthereareanumberofindividuals/familieswhoarejustmanagingand/orlivinginornearpoverty.InSt.Louis,24%ofthoseinterviewedidentifiedasjustmanagingorunabletomakeendsmeetincomparisonto,22%inCincinnati,35%inChicago41%inClevelandand42%inNY(SeeTable2).St.Louishas8%ofJewishhouseholdslivingbelow150%ofpoverty,whileChicagohas7%,Cleveland12%andNY19%.4IfonelooksatnearpoorJewishhouseholds,St.Louishas18%ofhouseholdsbeingdefinedasnearpoor(150%-250%ofFPL)whereasChicagohas4%,Clevelandhas7%(definedas150%-200%FPL)andNewYorkhas10%(150%-250%FPL).AscanbeseeninTable3,theSaintLouisJewishcommunityandtheSaintLouisCountyCaucasianpopulationappeartobemoresimilarintermsofageandincomethaneitherCaucasiansinthecityorAfricanAmericansineitherthecityorcounty.InSt.Louis,asinothercitiesacrosstheUS,Jewishfamilieslivingatornearpovertyhavefoundthemselvesseekinganumberofdifferentkindsofassistance.WithinSt.Louis,25%oftheJewishpoorand28%ofthenearpoorhaveidentifiedthemselvesasbeingfoodinsecure(cuttingthesizeoftheirmealsorskippingmealsbecausetherewasnotenoughmoneyforfood).5Thirty-sixpercentofJewishhouseholdsinSt.Louishavesoughtassistanceforatleastoneotherkindofservice(depression,housing,finances,disability,etc.).ThesechallengesinmakingendsmeetactalsoasasignificantbarriertoparticipatingJewishlife.ThosewithlowerincomesweremorelikelytoreportthatcostpreventedthemfromattendingJewishcamps,synagogues,andtheJCCinSt.Louis.ThestudiesconductedinBaltimore,ChicagoandClevelandfoundsimilarresults.6
4Ukeles,JB(2012)Ataleoffourcities:LearningaboutJewishCommunity.Presentationpresentedatthe2012GeneralAssemblyinBaltimore,MD.5JewishPolicy&ActionResearch.2014StLouisJewishCommunityStudy.6Ukeles,JB(2012)Ataleoffourcities:LearningaboutJewishCommunity.Presentationpresentedatthe2012GeneralAssemblyinBaltimore,MD.JewishPolicy&ActionResearch.2014St.LouisJewishCommunityStudy.
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Table1:Surveysamplesizes,bysamplingmethodandcity
• RDD:randomdigitdialing;DJN:distinctiveJewishnameTable2:Demographicinformationacross5cities
Year RDD* DJN List Total
SaintLouis 2014 216 30 757 1,003Chicago 2010 152 204 1,637 1,993Cincinnati 2008 228 0 684 912Cleveland 2011 114 36 894 1,044NewYorkCity 2011 3,377 451 2,165 5,993
SaintLouis(2014)
Chicago(2010)
Cincinnati(2008)
Cleveland(2011)
NewYork(2011)
#Jewishhouseholds 32,900 148,100 12,500 38,300 694,000#personsinJewishhouseholds(incl.non-Jewish) 89,300 381,900 33,000 98,300 1,769,000#persons≥65yearsinJewishhouseholds(%total)
15,806(17.7%)
67,978(17.8%)
6,100(18.5%)
17,400(17.7%)
354,000(20.0%)
#children0-5yearsbeingraisedJewish(%total)
2,000(2.2%)
19,842(5.2%)
1,360(4.1%)
4,200(4.3%)
107,274(6.1%)
Medianhouseholdincome,allJewishhouseholds $73,000 $89,000 $97,000 $73,000 $70,000Medianhouseholdincome,Jewishhouseholds≥65years $57,000 $66,000 $83,000 $53,000 $51,000
%householdsbelowFPL N/A N/A N/A N/A 10.90%%householdsreporting"justmanaging"or"cannotmakeendsmeet" 24% 35% 22% 41% 42%%respondentsreporting"fair"or"poor"health 18% 16% 13% 17% 25%
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Note:ComparisonbetweentheSaintLouisJewishcommunityandtheSaintLouisCountyCaucasianpopulationmaybemostmeaningful.Thesepopulationsarehighlightedinred.Thesedataarefromthe2015AmericanCommunitiesSurvey.Denominatorsmayvarybysurveyquestion.*Thereare17,600childreninJewishhouseholds.4,700areages0-4.**Becauseofdatalimitations,thisinformationispresentedasarange.Thedataindicatethatatleast1.9%ofJewishSt.Louishouseholdslivebelow100%FPLaccordingto2014cut-points.Thepovertystatusofanadditional4.7%ofJewishSt.Louishouseholdsmayfallintothiscategory.
Table3:ComparisonofCommunitieswithinSt.Louis Individual
slivinginJewishhousehold
Totalpopulation Caucasianpopulation African-Americanpopulation
Total County City Total County
City Total County
City
Populationsize 89,300
1,319,047
1,003,362
315,685
842,439
697,037
145,402
383,962
236,786
147,176
%male N/A 47.7% 47.4% 48.5% 48.5% 48.1% 50.5% 44.7% 44.1% 45.7%%<5years 5.3%* 6.0% 5.8% 6.7% 5.0% 4.9% 5.5% 7.1% 6.9% 7.3%%≥65years 17.7% 15.6% 16.8% 11.6% 17.7% 18.9% 12.2% 11.5% 11.5% 11.7%
%≥85years
6.0% 2.3% 2.6% 1.5% 3.1% 3.3% 1.8% 1.4% 1.3% 1.6%
%below150%FPL 8% 23.0 18.1 38.7 N/A N/A N/A N/A N/A N/A%below100%FPL N/A 14.8% 10.9% 27.1% 8.0% 6.6% 15.1 28.5% 22.4% 38.1%
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Factorsinfluencingaccesstoandutilizationofservices
MethodsIn-depthindividualinterviewswereconductedwithserviceprovidersfromJewishsocialserviceaswellassecularsocialserviceagencies(19)andindividuals/familiesintheJewishCommunitywhohaveusedservices(consumers)(12).Thoseinterviewedwerealsoaskedtocompleteaquantitativesurvey.Itshouldbenotedthatwefoundasomewhatfluidboundarybetweenthesetwocategoriesofindividuals,withsomeprovidershavingusedservicesinthepast,andsomeconsumershavingbeenprovidersinthepast.SurveyTwoquestionnairesweredeveloped.Thequestionnaireforproviderswasintendedtocapturethebreadthofservicesprovided,thepopulationsbeingserved,currentsourcesoffunding,gapsinfundingofservices,andanyadditionalneedsthatarecurrentlynotbeingmetbytheserviceagencythatrespondedorwithintheJewishCommunityatlarge.Thequestionnaireforconsumerswasintendedtocapturethefactorsinfluencingutilizationofservices,servicesthatconsumerswerelikelytoutilize,andsomebasicdemographicsinordertodescribethecharacteristicsofthesampleobtained.Individualinterviews:In-depthqualitativeinterviewswereconductedtoascertainproviderandconsumerimpressionsoffacilitatorsandbarrierstoservices,howpeopleinneedfindoutaboutservices,howservicesmightbebetterdelivered,gapsinservices,andsuggestionsforimprovingserviceaccessandutilization.IndividualswerecontactedbasedoninformationprovidedbytheJewishFederation.Inaddition,snow-ballsamplingwasused,withindividualsinterviewedprovidingthenamesofotherstheythoughtwouldbeparticularlyhelpfultocontacttolearnabouttheirperspectivesontheseissues.Theinterviewswereaudiotapedandtranscribedverbatim.Thetranscriptswerecodedbyaninitialcoderbasedonthegeneralquestionsaskedandreviewedbyoneormoreadditionalcoders.Theseinitialcodeswerefurthercategorizedasbelongingattheindividual,social/cultural,organizational,interorganizationalandcontextuallevels.
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SurveyResultsWepreparedtwosurveyinstruments,onefortheprovidersandonefortheconsumersofservices.ItemsweresimilartosurveyquestionsusedbyotherJewishFederationswithintheUSandwereselectedand/ormodifiedwithinputandfeedbackfromtheJewishFederationSaintLouisstafftoensuresurveyitemswereappropriatefortheSt.Louiscontext(seeappendixforquestionnaires).ServiceProvidersServiceprovidersindicatedthattheyprovidethefollowingservices:EarlyChildhoodEducation Camping(DayandResident) CulturalandEducational
ProgramsSocialServices(IndividualandGroup)
AdultDayCenter FoodServices(Pantry,Seniors,Families,MealDelivery)
FitnessandWellness YouthandFamilyPrograms Religious/SpiritualSocialJustice CommunityService Community
Building/OrganizingCounseling,Assessment,Testing
Psychiatry FinancialAssistance
ChildAbusePrevention Chaplaincy Providersindicatedthatfromtheirexperiencesthefourfactorsthatmayinfluenceconsumers’useofservicesmostarecost,stigma,familyobligationsandtransportation.Theyalsoindicatedthatthatfood,mentalhealthandchild-careserviceswerethemostutilizedservices.Servicesthatprovidersindicatedwerethemostwell-fundedwerecontinuingeducation,foodandmentalhealthservices.Housingrepair,substanceuse,andhousingaccesswereidentifiedastheleastwell-funded.Providersalsoindicatedthatwhileallservicescouldbenefitfromadditionalfundingandresourceallocation,food,eldercare,childcare,employment,andmentalhealthservicesweremostinneedofadditionalfunding.Oftheservicesweaskedprovidersabout,employment,childcare,housingrepair,mentalhealth,foodandhealthcareserviceswerementionedasbeingamongthegreatestneeds.Someprovidersalsoindicatedthatyouthhadadditionalneedssuchasorthodontics,music,art,dance,andsports.ConsumersTheaverageageofconsumerswhocompletedthequestionnairewas53,witharangeofagesbetween42and73.Fiftypercentofparticipantsdescribedthemselvesas“unabletomakeendsmeet,”andtheremaininghalfofparticipantsdescribedtheirhouseholdfinancialsituationas“justmanagingtomakeendsmeet.”Theparticipantswereprimarilyfemale(87.5%).Intermsofeducation,themajorityofparticipantshadanAssociatedegreeorsomecollegeexperience(66.67%).Themajorityofparticipants
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werereform(62.5%)withother“denominations”beingrepresentedat12.5%ofrespondentseach(orthodox,conservative,non-denominationaland“JustJewish”).Themajority(75%)ofparticipantsindicatedthatbeingJewishwasveryorsomewhatimportanttothem.WhilethissampledoesnotrepresentthecompletediversityoftheJewishpopulationexperiencingpovertyintheSt.Louisarea,thequalitativeandquantitativedataprovideddoessuggestsomeconsistentconcernsandpresentsomecompellingopportunitiesforimprovingservicestoenhanceaccessandutilization.Fiftypercentormorerespondentsindicatedthatthefollowingwerealways,often,orsometimesafactorinfluencingutilizationofservices:cost,stigma,agencyisJewishaffiliated,healthstatusandtransportation(seeTable4).Table4:FactorsinfluencingutilizationofservicesCost:55.56%statedthatthiswasalwaysoroftenafactor;11.11%statedthisissometimesafactor;and33.33%statedthisisneverafactor
Stigma:11.11%statedthatthiswasalwaysoroftenafactor;66.67%statedthisissometimesafactor;and11.11%statedthisisneverafactor
Communicationdifficultieswithproviders:11.11%statedthatthiswasalwaysoroftenafactor;22.22%statedthisissometimesafactor;and11.11%statedthisisrarelyafactor;and33.33%statedthisisneverafactor
Culturalorreligioussensitivity:44.44%statedthatthiswasalwaysoroftenafactor;44.44%statedthisisneverafactor
AgencyisJewishaffiliated:11.11%statedthatthiswasalwaysoroftenafactor;55.56%statedthisissometimesafactor;and33.33%statedthisisneverafactor
Jobobligations:33.33%statedthatthiswasalwaysoroftenafactor;11.11%statedthisissometimesafactor;11.11%statedthisisrarelyafactor;and44.44%stated
thisisneverafactor
Familyobligations:22.22%statedthatthiswasalwaysoroftenafactor;11.11%statedthisissometimesafactor;and66.67%statedthisisneverafactor
Transportation:44.44%statedthisissometimesafactor;11.11%statedthisisrarelyafactor;and44.44%statedthisisneverafactor
Healthstatus:33.33%statedthatthiswasalwaysoroftenafactor;55.56%statedthisissometimesafactor;and11.11%statedthisisneverafactor
Whenaskedabouthowlikelytheyweretouseavarietyofservices,overathirdoftherespondentsindicatedthattheywereverylikelytousethefollowing:housingrepair,employment,continuingeducation,mentalhealth,foodandhealthcare(SeeTable5).Itshouldbenotedthattheneedforsomeservicesmayhavebeendifferentinoursamplethantheoverallpopulationinneedbecauseofavarietyoffactorssuchasagedistributionorchildreninthehousehold.
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Table5:ServiceutilizationChildcare:66.67%respondedthattheynotlikelytousetheseservices;22.22%respondedthattheyaresomewhatlikelytousetheseservices;and11.11%respondedthattheyareverylikelytousetheseservices.
Servicesforchildrenandadultswithspecialneeds:66.67%respondedthattheynotlikelytousetheseservices;22.22%respondedthattheyaresomewhatlikelytousetheseservices;and11.11%respondedthattheyareverylikelytousetheseservices.
Eldercare:88.89%respondedthattheynotlikelytousetheseservices;and11.11%.
Housingrepair:33.33%respondedthattheynotlikelytousetheseservices;and66.67%respondedthattheyareverylikelytousetheseservices.
Housingaccess:66.67%respondedthattheynotlikelytousetheseservices;11.11%respondedthattheyaresomewhatlikelytousetheseservices;and22.22%respondedthattheyareverylikelytousetheseservices.
Employment:22.22%respondedthattheynotlikelytousetheseservices;33.33%respondedthattheyaresomewhatlikelytousetheseservices;and44.44%respondedthattheyareverylikelytousetheseservices.
Continuingeducation:22.22%respondedthattheynotlikelytousetheseservices;44.44%respondedthattheyaresomewhatlikelytousetheseservices;and33.33%respondedthattheyareverylikelytousetheseservices.
Substanceuse:88.89%respondedthattheynotlikelytousetheseservices;and11.11%respondedthattheyareverylikelytousetheseservices.
Mentalhealth:33.33%respondedthattheynotlikelytousetheseservices;22.22%respondedthattheyaresomewhatlikelytousetheseservices;and44.44%respondedthattheyareverylikelytousetheseservices.
Food:11.11%respondedthattheynotlikelytousetheseservices;22.22%respondedthattheyaresomewhatlikelytousetheseservices;and66.67%respondedthattheyareverylikelytousetheseservices.
Healthcare:22.22%respondedthattheynotlikelytousetheseservices;22.22%respondedthattheyaresomewhatlikelytousetheseservices;and55.56%respondedthattheyareverylikelytousetheseservices.
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QualitativeInterviewResultsSummary:Theproviderandconsumerinterviewsidentifiedanumberoffactorsthatinfluenceaccesstoandutilizationofservicesattheindividual,social/cultural,organizational,interorganizationalandcontextuallevels.Thesearesummarizedhereacrossproviderandconsumerinterviews.Thenextsectionprovidesmorespecificinformationfromtheproviderandconsumerinterviewsseparately.Intermsofindividuallevelfactorsthoseinterviewedindicatedthatthereisalackofinformationaboutservicesprovidedandtheeligibilityrequirementsforusingtheservices.Theyalsoindicatedthattherewasagreatdealofbureaucracyinaccessingservices.Respondentsalsoindicatedthatconsumersoftendonotwanttosharepersonalinformationinpartduetoembarrassmentregardinguseofservicesandinpartduetofearaboutwhathappensiftheiruseofservicesisdiscoveredbyothers.Therewereconcernsraisedaboutstigmathattheyidentifiedasbeingcreatedbythestructuresofaccessingcarenotonlyafunctionofindividualbeliefs.Intermsofsocial/culturalfactors,concernswereexpressedthatsomeprovidersmaynotbesensitivetotheuniqueneedsofJewishfamiliesandsomearticulatedalackofunderstandingofthedifferentneedsamongdenominationswithintheJewishcommunity.ThoseinterviewedalsoexpressedconcernsthatparticipatinginJewishcommunallifeisexpensive,puttingfamiliesinapositionwheretheyneedtorequestassistancebutdonotmeetmostfederaleligibilityrequirementsforservices.Itwasalsonotedthattheimportanceofthereligiousaffiliationoftheserviceagencyorspecificprovidervariesconsiderablyandtoalargeextentdependsonthetypesofservicesneeded.Inotherwords,religiousaffiliationislikelytomattermoreforthingslikefoodandmentalhealth,andlessforthingslikehousingandcarrepair.Intermsoforganizationalfactors,thoseinterviewedvoicedconcernsaboutunclearcriteriaforutilizationofservices,aswellasbureaucracyandrestrictionsonhowresourcescanbeused.Thoseinterviewedalsopointedtoconcernsaboutinsufficientservices,inconvenienthoursofservice,andlimitedlocationsandservicemodels.TherewerealsoconcernsthattheservicesprovidedwithintheJewishcommunityareinferior.Inpart,thiswasattributedtostaffturnover,andasaresultstaffnotknowingaboutserviceswithintheirownagencies.Intermsofinterorganizationalfactors,thoseinterviewednotedthatJewishagenciesoftendon’treferindividualsorfamiliestoeachother.Thiswasidentifiedasbeinginpartduetothefactthattheyareunawareofwhatotherorganizationsoffer.Theyalsonotedthesignificantproblemscausedbyinteragencysilos.Thoseinterviewedvoicedtheneedforinteragencyagreementstoeasetheuseofservices,andthesharingofcaseinformationtoreducetheburdenonfamilies.TheyalsohighlightedtheneedforJewishandnon-Jewishagenciestocreatewaystoshareinformationaboutservicesandworkmorecollaboratively.Inconsideringcontextualfactors,theoneissuethatwasnotedrepeatedlywaschallengeswithtransportation.Thoseinterviewedalsonotedthatthereisageneralneedforadditionalservices,particularlymentalhealthservices,homeimprovement,andnecessitiesbeyondfood(e.g.,toiletpaper,toothpaste).
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BarrierstoaccessandutilizationofservicesProvidersIndividualbarriers
Theprovidersinterviewedidentifiedanumberofindividuallevelfactorsthatinfluenceaccesstoandutilizationofservices.Oneofthemostimportantfactorsidentifiedisthatpeopleinthecommunitydon’tknowabouttheservicesavailable.Evenwhenpeopledoknowaboutservices,providersindicatedthattheindividualsandfamiliesmaynotknowiftheyareeligible.
Anotherbarrieridentifiedbyserviceprovidersisthattoaccessservicesoftenrequireson-lineorautomatedphoneservicesthatmanyinthecommunity,particularlytheelderly,arenotcomfortableusing.Providersalsofeltthatconsumersofservicesmaynotwanttodiscloseinformationthatisrequiredtoaccessservices.
Providersindicatedthatsomeindividualsandfamiliesdonotaccessorutilizeservicesbecausetheydonotself-identifyasbeinginneedofservices,aren’tmotivatedtouseservices,orareanxiousaboutgoingtounknownplaces.Providersalsohadexperienceswithindividualsandfamilieswhohavehadconcernsthatacknowledgingtheirproblemsandusingserviceslessenstheirdignity.Theyfeltthatsomeconsumersmayfeelembarrassedaboutthestigmaassignedtothemifothersfindoutabouttheirneeds.Theyalsohadexperiencesthatsuggestedthatconsumershaveconcernsabouttheimpactontheirbusinessesifpeopleinthecommunityweretodiscovertheyhavefallenondifficulttimes.Social/Culturalbarriers
Providersidentifiedsomeimportant,potentiallyunique,socialandculturalbarrierstoJewishfamiliesandindividualsaccessingandutilizingservices.AsstatedbyoneproviderthereisaquestionastowhetherornotthedifferentmanifestationofissueswithintheJewishcommunitywarrantsauniquesetofreflectivetoolsorevencriteriaforservices.Forexample,doesayoungpersonexperiencingmentalhealthchallengesneedaJewishcounselorsothattheresponsetotheissuescanbeconsistentwiththeteachingwithintheJewishtraditions?Similarly,whatiffamilieshavesufficientresourcestomeetwhatmightsecularlybedefinedasbasicneeds,buttheydonothavesufficientresourcestoallowtheirparticipationinJewishcommunallife,shouldtheybeeligibleforservices?
Whenaskedaboutreferrals,providersindicatedthattheymakereferralstoeitherJewishorsecularagenciesbasedonwhattheythinktheindividualconsumerisgoingtobecomfortablewithusing,andinSt.Louis“comfort”mayberelatedtogeographiclocationasmuchasreligiousaffiliation.Providersnotedthattheirdecisiononwheretoreferindividualsalsohastodowiththeindividualand/orfamilypreferenceregardingseekingcarewithintheJewishcommunity.SomeindividualsandfamiliesclearlyprefertostaywithintheJewishcommunity,otherspriceshop,andstillothersprefernottobeservedwithintheJewishcommunity.
OtherprovidersnotedthatsomepartsoftheOrthodoxcommunitydonotseeitasaquestionofthedifferencebetweentheJewishFederationrelatedservicesandsecularorotherreligiousdenominationservices.TheyseethattheOrthodoxcommunityhasauniquewaythattheyneedtobeservedandthateventheFederationoftendoesnotserveorrepresentthem.
Organizationalbarriers
Providersidentifiedanumberofbarrierswithintheirownorganizationsthatimpactaccesstoandutilizationofservicesincludinguncleareligibilitycriteria,toomuchbureaucracytoaccessservices,andrestrictionsandrulesthatlimitaccess.Anotherconcernvoicedbyprovidersisthatstaffturnoverisveryhighatsomeoftheorganizationswithinthecommunity.Peoplevoicedfrustrationoverlosingqualitystafftoservethecommunity.Thoseinterviewedalsonotedthatthishasledtosomenegativeexperiencesusingservicesandaperceptionthatthestaffwhostayworkingattheseagenciesareofinferiorquality.
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Providersalsovoicedaconcernthattheagenciesinthecommunityhaveinsufficientresourcestomeettheneedsinthecommunity.Thiswasinpartarticulatedasinsufficientfundingforexistingresourcesandinpartaconcernthattheservicesneededarenotavailable.Serviceprovidersacknowledgedthattherearemanymorepeoplewhocouldusetheservicesthanarecurrentlyusingthem.Thiswasinpartattributedtothingslikeservicehoursbeinginconvenientandinparttopeoplenotknowingthatservicesareavailableorpeoplewhodonothavethecapacitytoaskforhelp.
Providersalsonotedthatthereareanumberofdifferentvulnerablepopulationsinthearea–thosewhoarethemostvulnerableandunabletoseekhelp,thosevulnerableandabletorequestassistance,andthosewhoseekassistancebutmaynotreallyhavethesamekindsofneeds.Itmaywellbethateachisbestservedthroughdifferentagenciesorapproaches.Interorganizationalbarriers
Providersnotedthatthereareseveralchallengestoworkingacrossorganizationsthattakeawayfromservingthecommunityinthebestwaypossible.Forexample,agenciesoftendon’trefertoorreceivereferralsfromotherJewishagencies.Thiswasattributedatleastinparttonotknowingwhatserviceseachotheroffer.Providersalsoindicatedthatwhenreferralsareprovidedthereisofteninsufficientinformationsharedbetweenagencies,placinganadditionalburdenonindividualsandfamilies.Providersreportedthatthereareinteragencysilosandbarrierstoworkingtogether,andthatthereshouldbewaystostreamlineinteragencyservicestobetterservethecommunity.ContextualBarriers
Providersnotedsomecontextualfactorsthatserveasbarrierstoindividualsandfamiliesseekingservices.Mostnotably,providersmentionedthatthereare“terrible”publictransportationoptions.
ConsumersIndividualbarriers
Serviceconsumersidentifiedanumberofsimilarbarriersasthoseidentifiedbyserviceproviders.Forinstance,theynotedthatforsomeitisnoteasytoaskforhelp.Consumersalsovoicedatensionbetweenexperiencingexternalstigmaandinternalembarrassmentassociatedwithaskingforhelp,yetmostindicatedthatfromtheirexperienceitisacceptableinthecommunitytoaskforhelp.Infact,somestatedthatintheirmindstherealityisthateveryoneneedssomesortofhelpatsomepointintheirlives.
Anotherbarrierconsumersidentifiedwasthatmanyindividualsdonotknowwhatservicesareavailable.SomestatedthatthislackofawarenessisbecauseofthewaytheFederationandassociatedagenciesshareinformationaboutservices.Social/culturalbarriers
WhenaskedifaccessingandutilizingservicesmightbeinfluencedbywhetherornottheagencyisJewish,secularorhostedbyadifferentreligiousgrouptheoveralltakehomemessagewas”itdepends.”Forsomethereisageneralsenseof“yesitisimportant”or“noitisnotimportant”thattheindividualbeJewishortheagencybepartoftheJewishcommunity.Forothers,therearesomeserviceswherereligiousandcultural“fit”makeadifference(e.g.,food)butotherserviceswhere“fit”isnotanissue(e.g.,housing,clothing,carrepair).Forstillothers,particularlysomeelementsoftheOrthodoxcommunity,evenservicesprovidedwithinJewishagenciesareoftennotseenasfittingcommunityneeds.SomearticulatedthattheOrthodoxcommunitydoesnotalwaysexpect,ornecessarilywant,theseservicestobeprovidedbytheFederation.Rathertheyseetheseneedsasbeingmore
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appropriatelyaddressedbythesynagogueandcongregantsofthatsynagogue.SomeconsumershadsomeconcernswiththenotionthatJewishindividualsandfamiliesshouldbetakencareofbytheirownandshouldtakecareoftheirown,asforthemitreflectedconcernsaboutinsularity.Organizationalbarriers
Serviceconsumersidentifiedanumberoforganizationalbarrierstoaccessingandutilizingservicesincludinginconvenientservicehours,eligibilityrequirements,applicationprocesses,andthelackofflexibleservicemodels.Theyalsonotedthatthereseemtobemorepeopleinneedthanresourcesavailabletoservethem.
Consumersalsonotedthatpeopledon’tknowaboutservicessotheydon’tevencalltoobtainthem.Othersnotedthatwhentheyhavecalledlearnaboutservicesthestaffattheagenciesdidn’tknowaboutservicesofferedintheirownagency.Consumersemphasizedthattheservicesneededgoesbeyondfoodtohealthcare,mentalhealthcare/counseling,homerepair,utilities,furniture,clothes,domesticviolence,seniorservices,tutoringforschool,consolidatingdebt,jobs,loans,casemanagement,etc.
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FacilitatorstoaccessandutilizationofservicesProvidersIndividuallevelfacilitators
Whenproviderswereaskedaboutthekindsofthingthatfacilitateindividualsandfamiliesaccessingservices,firstandforemosttheyindicatedthatitisimportanttoensurethattheyknowthattheyarenottheonlyoneswhohavetheirneeds.Consumersneedtobeinteractedwithinwaysthathelptopreservedignityandensurethattheyunderstandthattheyarenotbeingjudged.Severalprovidersstatedthatthesemessagesshouldbehighlightednotonlyforthoseusingservicesbutalsowhenmarketingservices.Social/Culturalfacilitators
Providersnotedthatitisimportanttobuildrelationshipswithindividualsandfamiliessothattheyknowthatitisacceptabletocometothemwhenhelpisneeded.Organizationalfacilitators
Providersofferedsomesuggestionsthatwouldhelpindividualsandfamiliestoaccessservices.Inparticular,theyemphasizedincreasingreferralsbyinformingadvocatesandenhancingadvertising.Theyalsonoted,however,thatalreadytherequestsforservicesexceedwhattheycanprovide,soadditionalfundingandfundraisingareimportant.
Providersalsohighlightedthattherearethingsthatcanbedonetoreducetheburdenofthebureaucracyassociatedwithtryingtoaccesscare,suchasassistingwithcompletingandsubmittingformsandenhancinginteragencysharingofinformation.
Providersencouragedmoreflexibilitywithhowandwhereservicesareprovided,inotherwordsthecreationofalternativeservicemodels.Forsomethismeantgoingtoindividualshomestoprovideservices.Otherssuggestedprovidingfoodorclothingatsynagoguesorschools.ConsumersFacilitatorstoaccessandutilizationofservices
Whenserviceconsumerswereaskedaboutthatfacilitatesindividualsandfamiliesaccessingandutilizingservicesthey,liketheproviders,highlightedtheimportanceofemphasizingthatthateveryoneneedshelp.SomealsonotedthattheygototheirRabbitogetassistance.
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Opportunitiesforactionandreflection
OpportunitiesforactionBasedonourfindings,thereisnotonesinglebestapproachforimprovingservicestoJewish
individualsandfamilieslivinginpovertyintheSt.Louisarea.Ratherthemostimportantchangesmaybedifferentdependingonthecircumstance,theindividual,andtheirdenomination.However,bothprovidersandconsumershadsomekey,andconsistent,recommendations.Someoftheserecommendationsarethedirectextensionofchallengesthatwerehighlighted(e.g.,peopledon’tknowaboutservices),whileothersarestrategiesidentifiedbythoseinterviewed(e.g.,tellpeopleinthecommunityaboutservicesthroughprintmedia,socialmedia,orinperson).Morespecifically,thedatasuggestthatinordertoimproveaccesstoandutilizationofservicestheFederationneedsto1)improvemarketing/communicationtoincreaseawarenessofandinformationaboutservices,2)establishformalnetworksandcollaborationamongserviceproviders,3)createopportunitiesforprovidingon-going,confidentialfeedbackonhowtoimproveservices,and4)createalternativeserviceprovisionmodels.Marketing/communicationtoincreaseawarenessofandinformationaboutservices
Providersandconsumersemphasizedtheneedforincreasingtheamountandvarietyofinformationaboutservices.SpecificsuggestionsincludedwrittenorprintinformationthroughtheJewishLightorbulletinboardpostings,socialmedia/Facebook,andemailsthroughvariouslistserves.Itwassuggestedthatthesebedistributedinwaysthatdirectlyreachserviceprovidersandpotentialconsumers,aswellastothosewhointeractwithpotentialconsumerseitherbecauseoftheirformalrolesinthecommunity(e.g.,RabbisandCantors)ormoreinformallythroughelectronicmedia(Facebook,blogsorothersocialmedia)orinpersonsocialgroups.Creationofnetworksandcollaborationamongserviceproviders
Bothprovidersandconsumersechoedwhattheysawasthepotentialbenefitsofenhancingcollaborationandnetworkingamongserviceproviders.Therecommendationsincludeddevelopingbetterwaystoshareinformationbothaboutconsumersandservicesprovidedbytheagencies;enhancingcasemanagementand/orreferrals;andco-locatingservices(foodpantrytosynagogue,socialservicesatfoodpantry).ThesesuggestionscallupontheagenciesfundedbytheFederationandthosethatoperateoutsideofthisfundingtoworktogethertomovealongwhatsomehavecalledacontinuumofcollaboration:
• unlinked–donotworktogetheratall,• networking–shareinformationonly,• coordinating–mutualreferralandcomplimentaryorganizationalactionplanning,• cooperating–shareresourcesandhaveawrittenagreementtoformalizecollectiveaction,or• collaborating–jointactionthatmutuallybenefitseachorganizationandofteninvolvessharing
risks,responsibility,andrewards.7ThisisconsistentwithwhatotherJewishFederationshavefoundintheirworktobetterunderstandhowtoaddresspovertyintheircommunities.Forexample,inCleveland,OHtheJewishFederationconductedasimilarstudytothisoneandasaresultinitiatedaroundtableofallagenciesthatworkwith7Himmelman,A.T.Definitions,decision-makingmodels,roles,andcollaborationprocessGuide.
Minneapolis.HimmelmanConsulting;2002
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individualsandfamiliesindistress.Thegroupmeetsonaregularbasistolearnaboutwhateachisdoingandhowtheycanbesthelpeachothertoaccomplishtheirobjectives.Opportunitiesforon-going,confidentialopportunitiesforprovidingfeedbackonhowtoimproveservices
Basedontheresponsesfromprovidersandconsumersitappearsthatthereisminimalopportunityforconsumersandstaffofagenciestoidentifywhattheythinkisgoingwellandwhatcouldbeimprovedinserviceprovision.Buildingthisinonaregularbasiswill“normalize”theprocessofrequestingfeedbackandprovidevaluableinformationonwhatchangescanandneedtobemadetobetterservethecommunity.Alternativeserviceprovisionmodels
ThoseinterviewedalsoencouragedtheFederationtoconsiderthecreationofalternativeserviceprovisionmodels.SomeofthiswasseenasenhancingcasemanagementservicesprovidedwithintheJewishcommunitywhileothersencouragedtheuseofmoresecularservicessuchastheUnitedWay211line.Thoseinterviewedalsoenvisionedbroadertypesofchangessuchasagenciesgoingtoindividual’shomes,orprovidingmultipleservicesatsingleagencies.Stillothersarticulatedtheimportanceofworkingwithintheformalandinformalstructuresoftemplesandsynagoguestoeitherprovideprofessionalservicesatthetemple/synagogueitselfortotraincongregationmembersaboutservices,orwhatothershavecalledlaynavigatororadvocateprograms.
OpportunitiesforreflectionWearethey:Ourfindingsindicatethatconsumersandproviderspointedtosimilarfactorsfacilitatingandgettinginthewayofaccessingandutilizingservices.ThismaybeinpartbecausesomeoftheproviderswespokewithhadneededtouseFederationservicesatsomepointintheirlives,andsomeoftheconsumersactuallyworkedwiththeFederationorother/affiliatedsocialservicesatsomepointintheirlives.Whilesomeconsumersmentionedthatthereisastigmaassociatedwithusingservicesamongthosewespoketo(obviouslyalimitedsample)theysawmuchofthestigmaandshamebeingexacerbatedbyexternalperspectivesoftheagenciesservingthem.Theconsumerperspectivewasthateveryoneneedshelpnowandthen.Someconsumersindicatedthattheyexperienceserviceprovidersandstructuresas“labeling”themaspeoplewholiveinpovertyratherthanpeoplecurrentlyinneedofservices.Weobtainedabiasedperspective:Itisinevitablethatwewillmisssomeperspectives,particularlytheperspectivesofthoseinmostdirestraits.Themostvulnerableareunlikelytobeinaplaceorcomfortabletospeakwithusandreflectontheirexperiencesbecausetheyareinthemidstoftheirmostdifficulttimes.Itwasevident,however,thatthebiasedperspectiveweobtainedwasnotjustduetothis.Thebiasoftheinformationweobtainedwasexacerbatedbyagencyprovidershavingconcernsaboutconnectinguswiththeirconsumers.Forthemostpartagencyprovidersexpressedthisasafunctionoftheirconcernaboutconfidentiality.However,italsohighlightsthatmostagenciesdonothaveanon-going,confidentialmeansofenablingconsumerstoprovidefeedbackandsuggestionsonhowtoimproveservices.Itisimportanttohelpagenciesidentifystrategiesthatcanbeemployedtoensureconfidentiality.Definitionsof“basicneeds”differ:Itisimportanttotakeintoaccountthatsomefamilieshavethemoneyforwhatthesecularcommunitymightcallthebasics,butwhatisconsideredthebasicsfor
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participatinginJewishlife(specificsummercamps,visitstoIsrael)ismoreexpensive.Whatthismeansinpracticeisthatwhilefamiliesmayself-identifyasneedingassistanceandmayaskforhelptheymaybeturnedawaybecausetheydonotmeetfederalcriteriaforobtainingservices.Itisalsoworthnotingthatseveralhavequestionedifthefederalpovertyisthebestmetricforunderstandingneed.Somehavesuggestedthatabasiclivingmeasure(theamountthathouseholdswouldhavetoearntocovertheirbasicexpenses)isabettermetric.8Whataretheimplicationsof“wetakecareofourown?”:Weheardthisphraseseveraltimesoverthecourseofourinterviewswithbothprovidersandconsumers.Inpart,thiswasdescribedasafunctionofhistory;thatthebroadersecularcommunityhasnothistoricallyprovidedtheJewishcommunitywithservices.Ontheotherhand,somemembersoftheJewishcommunitynotedtheimportanceof“takingcareofourown”becausesecularservicesmightbeofferedinwaysthatarenotculturallysensitive.Thismightbeanythingfromhavingaproviderwhowearsaminiskirt,tosomeonehandlingfoodimproperly,tonotunderstandingculturalnorms.OneofthechallengesvoicedbyconsumersandprovidersasfacingtheJewishcommunityinSaintLouisistowhatextentshouldtheJewishcommunitybeprovidinguniqueservicesversusutilizingbroadercommunityservices?GiventheJewishcommunityisaheterogeneous,nothomogenous,community,ifthereareseparateservicestowhomshouldtheybegeared?ToaddevenmorecomplexityotheraskedabouttheextenttowhichtheJewishcommunityshouldprovideforotherswhodonotsharetheJewishfaithandculture?8https://www.stl.unitedway.org/2017/04/united-way-releases-new-basic-living-measure-region/
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Appendix:SurveyInstruments
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JewishFederationServiceProviderSurvey
StartofBlock:DefaultQuestionBlock
Q1Whatisthenameofyouragency?
________________________________________________________________
Q2Whatisyourroleintheagency?
________________________________________________________________
Q3Whatisthemission/goalofyouragency?
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
Q4Whatservicesdoesyouragencyprovide?
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
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________________________________________________________________
Q5HowoftendothefollowinginfluenceutilizationofservicesbyJewishindividualsandfamilieslivinginpoverty?
Always/Often(1)
Sometimes(2) Rarely(3) Never(4) Don'tKnow
(5)
Cost(1) ▢ ▢ ▢ ▢ ▢
Stigma(2) ▢ ▢ ▢ ▢ ▢
Communicationdifficultywithprovider(3) ▢ ▢ ▢ ▢ ▢
Culturalorreligious
sensitivity(4) ▢ ▢ ▢ ▢ ▢
AgencyisJewish
affiliated(5) ▢ ▢ ▢ ▢ ▢
JobObligations(6) ▢ ▢ ▢ ▢ ▢
Familyobligations(7) ▢ ▢ ▢ ▢ ▢
Transportation(8) ▢ ▢ ▢ ▢ ▢
HealthStatus(9) ▢ ▢ ▢ ▢ ▢
Other(Pleasespecifyand
indicatelevelofinfluence)(10) ▢ ▢ ▢ ▢ ▢
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Q6Belowpleaseindicatewhichservicesyourorganization/agencyprovides.Whichwouldyousayiswell-utilizedversusunderutilizedbyJewishindividualsandfamilieslivinginpoverty?
Don'tProvide(1) YesProvide(2) WellUtilized(3) UnderUtilized(4)
ChildCare(1) ▢ ▢ ▢ ▢
ElderCare(2) ▢ ▢ ▢ ▢
HousingRepair(3) ▢ ▢ ▢ ▢
HousingAccess(4) ▢ ▢ ▢ ▢
Employment(5) ▢ ▢ ▢ ▢
ContinuingEducation(6) ▢ ▢ ▢ ▢
SubstanceUse(7) ▢ ▢ ▢ ▢
MentalHealth(8) ▢ ▢ ▢ ▢
Food(9) ▢ ▢ ▢ ▢
HealthCare(10) ▢ ▢ ▢ ▢
Other:PleaseSpecify(11) ▢ ▢ ▢ ▢
Other:PleaseSpecify(12) ▢ ▢ ▢ ▢
26
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Q7Intermsoffunding,howwellfundedareeachoftheservicesyouprovide?
Don'tProvide(1) WellFunded(2) InsufficientlyFunded(3) NotFunded(4)
ChildCare(1) ▢ ▢ ▢ ▢
ElderCare(2) ▢ ▢ ▢ ▢
HousingRepair(3) ▢ ▢ ▢ ▢
HousingAccess(4) ▢ ▢ ▢ ▢
Employment(5) ▢ ▢ ▢ ▢
ContinuingEducation(6) ▢ ▢ ▢ ▢
SubstanceUse(7) ▢ ▢ ▢ ▢
MentalHealth(8) ▢ ▢ ▢ ▢
Food(9) ▢ ▢ ▢ ▢
HealthCare(10) ▢ ▢ ▢ ▢
Other:PleaseSpecifyand
indicateleveloffunding.(11) ▢ ▢ ▢ ▢
Other:PleaseSpecifyandindicateleveloffunding.(12) ▢ ▢ ▢ ▢
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Q8TowhatextentdoJewishindividualsandfamilieslivinginpovertyhaveanunmetneedforthefollowingservices?
Agreatneed(1) ModerateNeed(2) NoNeed(3)
ChildCare(1) ▢ ▢ ▢
ElderCare(2) ▢ ▢ ▢
HousingRepair(3) ▢ ▢ ▢
HousingAccess(4) ▢ ▢ ▢
Employment(5) ▢ ▢ ▢
ContinuingEducation(6) ▢ ▢ ▢
SubstanceUse(7) ▢ ▢ ▢
MentalHealth(8) ▢ ▢ ▢
Food(9) ▢ ▢ ▢
HealthCare(10) ▢ ▢ ▢
Schoolsupplies(13) ▢ ▢ ▢
Other:PleaseSpecifyandindicatelevelof
need.(11) ▢ ▢ ▢
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Q9Intermsoffunding,howwellfundedareeachoftheservicesinthecommunity,regardlessofwhetheryouprovidetheseservices?
WellFunded(1) InsufficientlyFunded(2) NotFunded(3)
ChildCare(1) ▢ ▢ ▢
ElderCare(2) ▢ ▢ ▢
HousingRepair(3) ▢ ▢ ▢
HousingAccess(4) ▢ ▢ ▢
Employment(5) ▢ ▢ ▢
ContinuingEducation(6) ▢ ▢ ▢
SubstanceUse(7) ▢ ▢ ▢
MentalHealth(8) ▢ ▢ ▢
Food(9) ▢ ▢ ▢
HealthCare(10) ▢ ▢ ▢
Other:PleaseSpecifyandindicatehowwell
funded.(11) ▢ ▢ ▢
Other:PleaseSpecifyandindicatehowwell
funded.(12) ▢ ▢ ▢
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Q10Whichofthefollowinggroupsareservedbyyouragency?PleaseCheckallthatapply.
▢ Children(Ages0-18)(1)
▢ Adults(Ages19-64)(2)
▢ Elderly(Ages64andup)(3)
▢ Families(4)
▢ IndividualFamiliesLivinginPoverty(5)
▢ Unemployed(6)
▢ IndividualswithIllnessorDisabilities(7)
▢ Caregivers(8)
▢ Males(9)
▢ Females(10)
Q11IsthereanythingelsethatyouthinkwouldbehelpfulforustoknowinordertobetteraddresstheneedsofJewishindividualsandfamilieslivinginpoverty?
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
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JewishFederationStudywithJewishCommunityMembers/Consumers
StartofBlock:DefaultQuestionBlock
StartofBlock:DefaultQuestionBlock
Q1Howoftendothefollowinginfluenceutilizationofservicesbyyouand/orothermembersoftheJewishCommunity?
Always/Often(1)
Sometimes(2) Rarely(3) Never(4) Don'tKnow
(5)
Cost(1) o o o o o Stigma(2) o o o o o
Communicationdifficultywithprovider(3) o o o o o Culturalorreligious
sensitivity(4) o o o o o AgencyisJewish
affiliated(5) o o o o o JobObligations
(6) o o o o o Family
obligations(7) o o o o o Transportation
(8) o o o o o HealthStatus
(9) o o o o o
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Q2Howlikelyareyouoryourfamilytousetheservicesbelowiftheywereavailable?
Notatalllikely(1)
Somewhatlikely(2) Verylikely(3) Don'tKnow(4)
ChildCare(1) o o o o Servicesfor
children/adultswithspecialneeds(2)
o o o o ElderCare(3) o o o o HousingRepair
(4) o o o o HousingAccess
(5) o o o o Employment(6) o o o o ContinuingEducation(7) o o o o SubstanceUse
(8) o o o o MentalHealth(9) o o o o
Food(10) o o o o HealthCare(11) o o o o Other:PleaseSpecify(12) o o o o Other:PleaseSpecify(13) o o o o
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Q3Whatisyourage?
________________________________________________________________
Q7Whichofthestatementsbestdescribesyourhousehold'sfinancialsituation?
o Cannotmakeendsmeet(1)o Justmanagingtomakeendsmeet(2)o Haveenoughmoney(3)o Havesomeextramoney(4)o Well-off(5)
Q9Pleaseindicateyourmaritalstatus.
o Married(1)o Livingwithapartner(2)o Singlenevermarried(3)o Divorced(4)o Separated(5)o Widowed(6)
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Q10Whatisyourgender?
o Male(1)o Female(2)o Transgender/Transsexual(3)
Q11Whatisthehighestlevelofeducationyouhaveattained?
o Highschooldiplomaorless(1)o GED(2)o AssociatesDegree(somecollege,non-B.S.N.nursingdegrees)(3)o Bachelors(includesNursingB.S.N.)(4)o Bachelorsplussomegraduatework(5)o MastersDegree,MastersLevel(6)o Ph.D.,Ed.D.,otherDoctorate(7)o J.D.,L.L.M.,J.S.D.(Lawyer)(8)o M.D.,O.D.,D.D.S.(Physician,Osteopath,Dentist)(9)
Q14Whatisthezipcodeofyourpermanentresidence?
________________________________________________________________
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Q12Whatisyourdenomination,ifany?
o Orthodox(1)o Conservative(2)o Reform(3)o Reconstructionist(4)o Nodenomination--JustJewish(5)o Other,PleaseSpecify(6)________________________________________________
Q13Atthistime,howimportantisbeingJewishinyourlife?Isit...
o Veryimportant(1)o Somewhatimportant(2)o Notveryimportant(3)o Notatallimportant(4)
EndofBlock:DefaultQuestionBlock