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Tuesday, November 3, 2009: 3:25 PM
Learning Objective 1: The learner will be able to describe health disparities and their relationship to poverty and limited education.
Learning Objective 2: The learner will be able to describe practice and policy interventions that are health protective of low income women with children.
Health for All is a focus of the World Health Organization (WHO) and in the United States , it is translated into 10-year goals. The current set of goals, entitled Healthy People 2010, identifies health disparities in the United States as linked to poverty and limited education. Population groups with the highest poverty rates and least education generally have the worst health status. US welfare reform policy, Temporary Assistance for Needy Families (TANF), is a work-based program that limits the time families could use welfare. It represents a major policy shift that has exposed the disparities already present within this population.
The purpose of this qualitative narrative interview study was to gain in-depth understanding of the health, socio-cultural, and occupational experiences of women who have been unsuccessful at becoming work-ready and employed through work-based welfare. The setting was a large urban community. Participants were 41 women who were terminated from TANF after using up their 5-year lifetime limit of cash support. Targeted chain referral was used to recruit the women. Instruments were a semi-structured interview guide. Up to four interviews were conducted with each woman over the course of a year. Interviews were transcribed verbatim and entered into NVIVO software to facilitate data management. Coded interviews were analyzed using multistage narrative analysis. Findings suggest personal and family health challenges are barriers that deny women sustainable work, and limit family self-management. Findings also support the need for evidence-based public health data and welfare policy development to reduce health disparities and improve outcomes. The study provides policy makers and health care decision makers with information about the health impact of welfare reform policy, and innovative solutions that are health protective of low income women with children. These solutions can serve as blueprints for achieving Healthy People 2010 and Healthy People 2020 goals for the nation. This longitudinal study was funded by the National Institute for Child Health and Human Development (NICHD), 1 R01 HD 054961-01-A2; data were gathered between 2007 and 2009.
The purpose of this qualitative narrative interview study was to gain in-depth understanding of the health, socio-cultural, and occupational experiences of women who have been unsuccessful at becoming work-ready and employed through work-based welfare. The setting was a large urban community. Participants were 41 women who were terminated from TANF after using up their 5-year lifetime limit of cash support. Targeted chain referral was used to recruit the women. Instruments were a semi-structured interview guide. Up to four interviews were conducted with each woman over the course of a year. Interviews were transcribed verbatim and entered into NVIVO software to facilitate data management. Coded interviews were analyzed using multistage narrative analysis. Findings suggest personal and family health challenges are barriers that deny women sustainable work, and limit family self-management. Findings also support the need for evidence-based public health data and welfare policy development to reduce health disparities and improve outcomes. The study provides policy makers and health care decision makers with information about the health impact of welfare reform policy, and innovative solutions that are health protective of low income women with children. These solutions can serve as blueprints for achieving Healthy People 2010 and Healthy People 2020 goals for the nation. This longitudinal study was funded by the National Institute for Child Health and Human Development (NICHD), 1 R01 HD 054961-01-A2; data were gathered between 2007 and 2009.