The impact of welfare reform on parents' ability to care for their children's health.

Abstract

OBJECTIVES: Most of the national policy debate regarding welfare assumed that if middle-income mothers could balance work while caring for their children's health and development, mothers leaving welfare for work should be able to do so as well. Yet, previous research has not examined the conditions faced by mothers leaving welfare for work. METHODS: Using data from the National Longitudinal Survey of Youth, this study examined the availability of benefits that working parents commonly use to meet the health and developmental needs of their children; paid sick leave, vacation leave, and flexible hours. RESULTS: In comparison with mothers who had never received welfare, mothers who had been on Aid to Families with Dependent Children were more likely to be caring for at least 1 child with a chronic condition (37% vs 21%, respectively). Yet, they were more likely to lack sick leave for the entire time they worked (36% vs 20%) and less likely to receive other paid leave or flexibility. CONCLUSIONS: If current welfare recipients face similar conditions when they return to work, many will face working conditions that make it difficult or impossible to succeed in the labor force at the same time as meeting their children's health and developmental needs.

Emergency Department and Urgent Care for Children Excluded From Child Care

“…27,33 Our additional findings that parents at higher risk for using ED/UC settings for child care illnesses were African American parents and single parents are also consistent with previous studies. 23,25 Our study did not find that Hispanic families were at higher risk for ED/UC use, consistent with studies revealing that Hispanic families are more dependent on child care provided by extended families. 38,39 Parents without sick leave benefits face a considerable dilemma as they risk either loss of wages or loss of a job to stay home with a sick child excluded from child care.…”

“…8,9,21,22 Consequently, child care providers unaware of AAP national child care recommendations may increase parents' perceived need for urgent medical evaluations for nonurgent conditions to avoid loss of wages or missed time from work. [23][24][25][26] An estimated 50% to 80% of the 25 million pediatric visits to the emergency department are for nonurgent conditions. [27][28][29][30] High emergency department (ED) utilization for nonurgent conditions leads to increased cost, prolonged wait times, patient dissatisfaction, and adverse events.…”

Parents’ Daily Time With Their Children: A Workplace Intervention

“…[1][2][3][4][5][6][7][8][9][10][11] This is the first study to demonstrate that a workplace intervention designed to train managers to be supportive of employees' personal and family life 21,26 and increase employees' control over when and where they work 17 can increase employees' time with their children. Parents in the STAR intervention reported an average of 39 minutes more time per day or 4.5 hours per week with their child at 1 year after intervention.…”

“…Shared activities promote close, nurturing relationships that are critical for youths' psychological and behavioral adjustment [1][2][3] and for their ability to develop close relationships with peers and romantic partners. 4,5 Parent-child shared time also affords opportunities for parents to monitor their children's activities and deter health risk behaviors, 6 promote healthful eating and exercise, 7,8 arrange health care appointments, 9,10 and foster skills and knowledge that are important for youths' current and future successes. 11 With longer work days and commute times, more nonstandard work schedules, and greater work stress, it is more difficult to be a parent today than in the past.…”

“…By promoting schedule control in the context of supervisor support, STAR may have provided more flexibility for parents to spend time when their adolescent-aged offspring were available, and such time investments are known to have positive downstream implications for youth adjustment. [1][2][3][4][5][6][7][8][9][10][11] Important to note is that this study tested the effects of a workplace intervention on quantity but not quality of parent-child time. Although more time together brings opportunities for positive parentchild experiences, it does not guarantee them.…”