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Primary and reproductive healthcare access and use among reproductive aged women and female family planning patients in 3 states

May 24, 2023

Public funding plays a key role in reducing cost barriers to sexual and reproductive health (SRH) care in the United States. In this analysis, we examine sociodemographic and healthcare seeking profiles of individuals in three states where public funding for health services has recently changed: Arizona, Iowa, and Wisconsin. In addition, we examine associations between individuals' health insurance status and whether they experienced delays or had trouble in obtaining their preferred contraception. This descriptive study draws on data collected between 2018 to 2021 in two distinct cross-sectional surveys in each state, one among a representative sample of female residents aged 18–44 and the other among a representative sample of female patients ages eighteen and older seeking family planning services at healthcare sites that receive public funding to deliver this care. The majority of reproductive-aged women and female family planning patients across states reported having a personal healthcare provider, had received at least one SRH service in the preceding 12 months, and were using a method of birth control. Between 49–81% across groups reported receiving recent person-centered contraceptive care. At least one-fifth of each group reported wanting healthcare in the past year but not getting it, and between 10–19% reported a delay or trouble getting birth control in the past 12 months. Common reasons for these outcomes involved cost and insurance-related issues, as well as logistical ones. Among all populations except Wisconsin family planning clinic patients, those with no health insurance had greater odds of being delayed or having trouble getting desired birth control in the past 12 months than those with health insurance. These data serve as a baseline to monitor access and use of SRH services in Arizona, Wisconsin, Iowa in the wake of drastic family planning funding shifts that changed the availability and capacity of the family planning service infrastructure across the country. Continuing to monitor these SRH metrics is critical to understand the potential effect of current political shifts.

What Americans Think About Philanthropy and Nonprofits

April 6, 2023

The United States is "diversifying even faster than predicted" across multiple facets of society (Frey, 2020), especially race, ethnicity, and age. The 2020 census revealed increased diversity in every state and larger ethnic, racial minority, young, and aging populations across the country (Henderson, 2021). These demographic changes have implications for the nonprofit sector at every level, including building a more diverse donor base, addressing representation in the leadership of nonprofits, and managing complex needs and interests on the service side of the nonprofit equation.Despite philanthropy's long, deep traditions and importance to many Americans, recent data trends have surfaced that have rekindled concerns about the health of the sector. Two such challenges are the declining number of donors and the general decline in trust in all institutions.Our report seeks to examine the general attitudes and perceptions of philanthropy and the nonprofit sector, including assessing the extent to which current debates within the field play out in public today.After summarizing the key questions and findings addressed in this report, we provide an overview of the data and methods used in the study and discuss background information on the major critiques of philanthropy. The body of the report dives deeper into the key questions and findings before concluding with a discussion of the impact of these findings for practitioners and scholars.

Roadmap for Wildfire Resilience: Solutions for a Paradigm Shift

March 8, 2023

Though fire is a natural ecological process in many forest ecosystems, extreme wildfires now pose a growing threat to the nation's natural resources and communities. These trends will continue to worsen absent bold and transformative policy action to change the trajectory of how we manage and prepare for wildfire impacts.The Nature Conservancy and the Aspen Institute have spent the last year responding to this opportunity by hosting a series of workshops that sought input from all levels of government, Tribal Nations, the private sector, fire-prone communities, philanthropists, academics and other stakeholders, culminating in a Roadmap for Wildfire Resilience. The Roadmap concentrates on the two pillars of the 2014 National Cohesive Wildland Fire Management Strategy—resilient landscapes and fire-adapted communities—that require an investment commensurate with the third pillar—safe and effective wildfire response—to alter the current wildfire trajectory. This Roadmap weaves together lessons from decades of policy and practice with forward-thinking approaches that incorporate new technology and knowledge.Decision makers, advocates and other interested readers are invited to use this Roadmap to advance a more strategic and coordinated approach to wildfire resilience in ways that contribute to addressing climate change, promoting ecosystem health, advancing economic recovery and supporting historically underserved and excluded communities.

Understanding the Partisan Divide: How Demographics and Policy Views Shape Party Coalitions

February 6, 2023

To win congressional majorities, Democratic and Republican parties must stitch together coalitions that are broad enough to accommodate their stronghold districts and swing districts, but distinct enough to differentiate themselves from each other. How each party builds these coalitions depends, in part, on the demographic characteristics and policy views of voters in districts where they garner most support and how these overlap with voters in competitive districts.In this report, we show how Democratic and Republican districts differ from each other and where they overlap with competitive districts. Democratic districts tend to be more affluent and more diverse than Republican districts, which are mostly poorer and predominantly white. Competitive districts comprise roughly equal shares of districts that are more and less affluent than the district average, but they tend to be whiter than the average district. The winner-take-all electoral system accentuates these differences and reduces the diverse constellation of districts to a binary. This results in an inadequate representation of voters in districts that are far from the median Democratic or Republican district.

Undecided Voters: Who They Are, What They Want, and How They Decide Our Politics

November 7, 2022

Every election cycle, campaigns try to persuade undecided voters to support their side. Whether undecided voters are receptive to campaigns and how they end up voting—if they turn out at all—often proves pivotal in deciding elections. But who are these undecided voters and what policies do they want? Using a rich public opinion dataset, we analyze the demographics and policy preferences of undecided voters and how they differ from partisan voters. Undecided voters tend to be younger, have lower levels of educational attainment, and lower household incomes compared to Democratic and Republican voters. Undecided voters are also less interested in politics and largely equivocal about the Democratic and Republican parties. In terms of policy, undecided voters are not unified by shared positions towards social and economic issues. Instead, they have many different combinations of policy preferences, making it challenging to determine what they want from politics. Reforms like fusion balloting or proportional representation could allow for the emergence of new parties that could find ways to engage and provide better representation for these voters.

Creativity Challenge: The State of Arts Education in California

September 7, 2022

California has long maintained ambitious goals for arts education. The state Education Code requires schools to offer courses of study in four arts disciplines to all California K–12 students. In 2005/06, with support from the William and Flora Hewlett Foundation, SRI Education researchers conducted a study of arts education in California. Our goal was to assess schools' arts programs relative to state goals, examine the systems of support for these programs, and identify ways in which state and local policymakers might improve conditions for young people to experience arts education in schools. In 2019, the Hewlett Foundation engaged SRI to "refresh" the 2007 study. In most ways, the current study addresses the same research questions and relies on the same research design and data sources as the earlier report—a statewide school survey, case studies, and analysis of extant data provided by the California Department of Education. The context, however, has changed. Perhaps most prominently, in 2013, with the Local Control Funding Formula (LCFF), California radically changed its system for funding schools. Importantly, we examined arts education in California schools in school year 2019/20 and as such the data collected for this study reflect the status of arts education in California prior to the pandemic. In 2021 and 2022, before the release of this report (but after data collection), California enacted a host of new policies that may improve students' opportunities to experience arts education in schools.Overall, we found that, while much remained the same in 2020 as in 2006, some aspects of arts education in California's K–12 schools had improved. These improvements coincide with funding increases associated with LCFF and career and technical education (CTE), coordinated advocacy efforts, changes to the state accountability system, and substantial increases in support from school districts, counties, and partner organizations. Nonetheless, despite improvements, California schools still fall short of state goals for arts education and a persistent pattern of inequity emerges from our current data.

Insights from Hewlett Foundation’s Performing Arts OE-EID Grants

August 31, 2022

In 2019, the William and Flora Hewlett Foundation Performing Arts Program, in collaboration with a community advisory council, awarded a round of 39 grants to support Bay Area performing arts organizations in building their capacity around equity, inclusion, and diversity (referred to as the Organizational Effectiveness - Equity, Inclusion and Diversity or OE-EID grants) through a participatory grantmaking process.To reflect on this round of grants, the Performing Arts Program engaged Community Wealth Partners to conduct an assessment. The assessment process engaged a group of 10 leaders whose organizations had received an OE-EID grant as a grantee learning team to make meaning of data from grant reports and develop recommendations for the foundation based on the data and their own experiences. The Performing Arts Program and Community Wealth Partners chose this approach because it would focus on the perspectives of grantees, yield more detailed information about grantees' experiences than what was included in the grant reports, and create an opportunity for two-way conversation between the Performing Arts Program and grantees about promising practices and implications for the future.This document shares quantitative findings from a review of 26 final grant reports1 (from the 39 grants made) as well as insights and recommendations that came out of the work of the grantee learning team.

Information Gaps and Misinformation in the 2022 Elections

August 2, 2022

The problem of election misinformation is vast. Part of the problem occurs when there is high demand for information about a topic, but the supply of accurate and reliable information is inadequate to meet that demand. The resulting information gap creates opportunities for misinformation to emerge and spread.One major election information gap developed in 2020, when the Covid-19 pandemic drove many states to expand access to voting by mail. Inadequate public knowledge about the process left room for disinformation mongers to spread false claims that mail voting would lead to widespread fraud. Election officials could not fill information gaps with accurate information in time. As is now well known, no less than former President Trump promoted these false claims, among others, to deny the 2020 presidential election results and provoke the January 6, 2021, attack on the U.S. Capitol.In 2022, false narratives about a stolen 2020 election persist, even as an unprecedented spate of restrictive voting law changes across the country has created fresh information gaps and, thus, fresh opportunities for misinformation. Since 2020, at least 18 states have shrunk voting access, often in ways that dramatically alter procedures voters might remember from the past. Meanwhile, lies and vitriol about the 2020 election have affected perceptions of election administration in ways that complicate work to defend against misinformation.This paper identifies some of the most significant information gaps around elections in 2022 and new developments in elections oversight that will make it harder to guard against misinformation. Ultimately, it recommends strategies that election officials, journalists, social media companies, civic groups, and individuals can and should use to prevent misinformation from filling gaps in public knowledge. Lessons from other subjects, such as Covid-19 vaccine ingredients and technologies, show how timely responses and proactive "prebunking" with accurate information help to mitigate misinformation.

Much Alarm, Less Action: Foundations & Climate Change

July 14, 2022

Despite the urgency of climate change and the narrowing window for action, philanthropic funding to address climate change remains very limited. Total philanthropic giving by foundations and individuals focused on climate change mitigation represents less than two percent of total global philanthropic giving, according to the ClimateWorks Foundation. While there is some evidence of increased momentum in recent years, more action will be needed to match the scale of the climate crisis.

The impact of policy changes from the perspective of providers of family planning care in the US: results from a qualitative study

July 6, 2022

In recent years, there have been several state and federal policies that have disrupted access to publicly supported family planning care in the United States, including the 2019 rule that altered the federal Title X family planning program. In late 2020, we conducted in-depth interviews with health care providers from 55 facilities providing family planning care in Arizona, Iowa, and Wisconsin with the aim of learning how sites were affected by policy changes. We identified perceived effects on clinic finances, patient confidentiality, contraceptive counselling and service provision, and options counselling resulting from state and federal policy changes. Some clinics lost funding and had to pass some of the cost of services on to patients, raising new confidentiality concerns and creating new burdens on staff to carry out financial counselling with patients. Other sites had to grapple with restrictions on the pregnancy options counselling that they could provide, concentrate counselling on fertility awareness-based methods, and increase efforts to include parents/guardians in the care of adolescent patients. State and federal policies impact how publicly supported family planning care is provided, and compromise efforts to provide patient-centered care.

IWPR Reproductive Rights Index: A State-by-State Analysis and Ranking

July 1, 2022

IWPR intends that legislators, advocates, and stakeholders use this report to understand the disparities in women's reproductive rights and care in the United States, and that such understanding will enable them to take action at the local, state, and federal levels.This report demonstrates the need to protect and expand access to reproductive health services, including abortion, at the federal and state levels. Reproductive rights and freedom for women often are determined, in part, by their state of residence, including its political culture, and their ability to access or pay for care. This should not be the case. Access to comprehensive, evidence-based reproductive health care is a fundamental human and civil right.

Centering equity and justice in climate philanthropy

June 9, 2022

According to available funding data, most institutional funders do not incorporate climate or climate justice strategies into their work despite its urgency and potential, largely relegating it to a few environmental funders. As a result of underestimating its importance and its connection to other philanthropic priorities, not enough funding is flowing to climate change efforts and even less of it for reducing harm to communities most impacted by the climate crisis.This field guide for funders identifies common barriers to supporting climate justice strategies, describes ways to overcome them, and shares insights and case studies from experienced funders who have helped their institutions use a climate justice lens for greater impact within their existing grantmaking priorities.