Welfare, work, and health care access predictors of low-income children's physical health outcomes

Abstract

This analysis examines whether young children's (N= 494) general physical health is associated with parental employment, welfare receipt, and health care access within a low-income population transitioning from welfare to work. A latent physical health measure derived from survey and medical chart data is used to capture children's poor health, and parental ratings of child health are used to identify excellent health. Controlling for a host of factors associated with children's health outcomes, results show that children of caregivers who are unemployed and off welfare have better health than children of caregivers who are working and off welfare. Children whose caregivers are unemployed and on welfare, or combining work and welfare, have health outcomes similar to children of caregivers who are working and off welfare. Health care access characteristics, such as gaps in health insurance coverage, source of primary care setting, and type of health insurance are associated with children's general physical health. Implications of these results for state TANF programs are discussed.Children in low-income families are more likely to be reported by their caregivers as having poor health and have been shown to have higher rates of mortality, disability, and cooccurring health conditions than children from higher-income families (Starfield, 1997;

What We Know, What We Don't Know, and What We Need to Know about Welfare Reform

“…Kaestner and Lee (forthcoming) find very small, negative effects on infant health. Slack, Holl et al (2007) find no correlations between child health outcomes and the welfare or work patterns among former welfare recipients. The strongest evidence of health-related problems comes from Haider, Jacknowitz, and Schoeni (2003), who find significant declines in breastfeeding due to welfare reform.…”

Socioeconomic Status and DNA Methylation from Birth Through Mid-Childhood: A Prospective Study in Project Viva

“…The exposure of interest in this study was SES during the prenatal period. We created an SES index based on individual-and neighborhood-level metrics that are either associated with health outcomes of the child in Project Viva (e.g., maternal education, marital status, annual household income), or have been implicated as determinants of health in the literature (e.g., neighborhood-level income [22], use of welfare programs [23]). Individual-level SES metrics included maternal education level, marital status, self-reported income at enrollment and receipt of public assistance.…”

How are children and families faring a decade after welfare reform? Evidence from five non-experimental panel studies

“…The issue begins with an article by Slack et al (2006a) that summarizes trends in family economic well-being following PRWORA among TANF involved families who participated in the five studies. The article first describes the economic and policy contexts in which PRWORA was passed and summarizes the results of the experimental evaluations that preceded welfare reform, and the subsequent TANF "leaver" studies.…”