Book Description

The Personal Responsibility and Work Reconciliation Act of 1996 brought several changes to the welfare system. Among these changes are lifetime limits for receiving welfare benefits, and work requirements intended to foster economic self-sufficiency in welfare recipients. In the past few years, it has been acknowledged that there are challenges and barriers to the latter requirement such as quality affordable childcare, transportation, and the availability of suitable jobs. Also needing to be addressed are the health concerns of family members that may also present as a challenge or barrier to attempts to obtain and maintain economic self-sufficiency. This study examined how health functions as a challenge or a barrier to economic self-sufficiency in a low-income rural population. The sample consisted of 73 families enrolled in the Rural Families Speak Project, a multistate collaboration examining the effects of welfare reform on the well-being of low-income rural families. Mothers are the primary respondents to semi-structured interviews consisting of open-ended questions and fixed choice survey measures. Using qualitative research methods, and guided by an ecological perspective that considers multiple levels of influence on individuals and families, interviews were analyzed for thematic content having to do with health, well-being, mental health, and experiences with and perceptions of welfare. Quantitative findings are reported well. Findings indicated that health interferes with economic self-sufficiency in several ways. Adult health problems can limit or preclude the ability to find and keep work or acquire an education, as well as require out of pocket expenditures when adults are uninsured or underinsured. Child health problems can affect families in the same ways, and by limiting or interfering with the child's own education. Furthermore, welfare and other social agency policies may impact the health of low-income populations through the reduction of services. Socioeconomic position can influence health outcomes through several different means, including access to and availability of health care, public and private social relationships, exposure to adverse conditions at home and in the workplace, social deprivation, and the social milieu. It is suggested that welfare policymakers consider these factors and adopt an ethic of care when making welfare policy decisions.