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Monitoring the Impact of Welfare Reform  on Women's Health

Welfare reform, as outlined in the Personal Responsibility and Work Opportunity Act of 1996 (PRWORA), in state welfare waiver programs, and in changes to related public programs (e.g., JOBS, child care), has become an area of focus for a broad array of national and regional professional, policy, and research organizations as well as academic public health programs and faculty.

The Temporary Assistance for Needy Families (TANF) program's time and other requirements have the potential to affect the physical and mental well-being of women who participate in the program; this topic had been generally neglected in prior research studies.

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The primary aim of this assessment was to raise awareness about the relevance of welfare reform to women's health, and areas in which monitoring the impact of welfare reform on women's health might be accomplished. Drs. O'Campo and Rojas-Smith summarized the findings of studies examining this issue, specifically: 

  1. Effects of poverty on health
  2. Patterns of employment among welfare participants and the health consequences of low-wage work on women
  3. Domestic violence among welfare recipients
  4. Potential health consequences of the new provisions of TANF for women's and adolescent health, and 
  5. Consequences of the new TANF provision for the health and well-being of immigrant women.

A manuscript entitled "Welfare Reform and Women's Health: Review of the Literature and Implications for State Policy" was published in the Winter 1998 issue of the Journal of Public Health Policy. The WCHPC also produced a related policy brief for state and local MCH programs and other national, state, and local policymakers (Fall 1998).

The project team subsequently explored the perceptions of Regional Women's Health and TANF Coordinators and the Women's Health contacts and TANF Program Administrators in the 50 states on how welfare reform activities are impacting women facing domestic violence, immigrant women, adolescent mothers, and poor women in general. Also examined were states' welfare and women's health monitoring activities.

In addition, this project identified a broader range of issues states are experiencing relevant to welfare reform and women's health, and reported on these findings in both a policy brief (2001) and a manuscript, "Welfare reform and women's health: Challenges and opportunities to advance the public response to the health needs of poor women through monitoring and collaboration," (2002, Journal of Prevention and Intervention in the Community, 23 (1/2): 129-149).

Project leads are Patricia O'Campo, Lucia Rojas-Smith, and Holly Grason.



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