Welfare reform, enacted more than 5 years ago, created dramatic changes in the lives of single mothers living in poverty. The purpose of this study was to describe the lives of women who were unable to sustain involvement with work-based welfare. A multimethodological design and snowball sampling were used to gather qualitative and quantitative data from 31 urban women. Instruments were a demographic form, an interview guide, and the General Well-Being Schedule from the U.S. Health and Nutrition Examination Survey. Interviews were taped, transcribed, and entered into software to facilitate analysis. Thematic coding and narrative analysis were done. The study population had higher levels of severe and moderate distress than the reference standards for the general population. Barriers within the Temporary Assistance for Needy Families (TANF) system and personal barriers were identified by the women. Policy changes that address these obstacles would serve as blueprints for achieving the Healthy People 2010 goals for the nation.
Aday, L. (2001). At risk in America: The health and health needs of vulnerable populations in the United States (2nd ed.). San Francisco: Jossey-Bass.
2.
Anderson, S. G., Halter, A. P., and Gryzlak, B. M. (2004). Difficulties after leaving TANF: Inner-city women talk about reasons for returning to welfare. Social Work, 49(2), 185-194.
3.
Brauner, S., and Loprest, P. (1999). Where are they now? What states’ studies of people who left welfare tell us. New Federalism: Issues and options for states (No. Series A 32). Washington, DC: Urban Institute.
4.
Brown, A. (2001). Beyond work first (No. 2001-04-01). Retrieved December 13, 2003, from http:/www.mdrc.org/publications_bytitle_B.html.
5.
Burton, L. M., Lein, L., and Kolak, A. (2005). Health and mothers’ employment in low income families. In S. Bianchi and L. Casper (Eds.), Work, family health and well-being (pp. 493-509). Hillsdale, NJ: Lawrence Erlbaum.
6.
Cancian, M., and Myer, D. (2000). Work after welfare: Women’s work effort, occupation and economic. Social Work Research, 24(2), 69-86.
7.
Chavkin, W., and Wise, P. (2002). The data are in: Health matters in welfare policy. American Journal of Public Health, 92(9), 1392-1395.
8.
Crewe, S. (2002). Motivated but fearful: Welfare reform, disability, and race. Journal of Health and Social Policy, 16(1-2), 55-68.
9.
Danziger, S., Corcoran, M., Danziger, S., Heflin, C., Kalil, A., Levine, J., et al. (2000). Barriers to the employment of welfare recipients. Ann Arbor: University of Michigan, Poverty Research and Training Center, School of Social Work.
10.
Dupuy, H. (1977). A concurrent validation study of the NCHS general well-being schedule (No. HRA 78-1347). Washington, DC: U.S. Department of Health, Education and Welfare.
11.
Earle, A., and Heymann, S. (2002). What causes job loss among former welfare recipients?The role of family health problems. Journal of the American Medical Women’s Association, 57(1), 5-10.
12.
Flaskerud, J. (2002). Health disparities research: From concept to practice. Communicating Nursing Research, 35, 3-13.
13.
Flores, G., Bauchner, H., Feinstein, A., and Nguyen, U. (1999). The impact of ethnicity, family income, and parental education on children’s health and use of health services. American Journal of Public Health, 89(7), 1066-1071.
14.
Heymann, S., and Earle, A. (1999). The impact of welfare reform on parents’ ability to care for their children’s health. American Journal of Public Health, 9(4), 477-499.
15.
Hildebrandt, E. (2002). The health effects of work-based welfare. Journal of Nursing Scholarship, 34(4), 363-368.
16.
Hildebrandt, E., and Kelber, S. (in press). Perceptions of health and well-being among women in a work-based welfare program. Public Health Nursing.
17.
Holzer, H. (2002). Do we need a stronger welfare policy for a weaker economy? Short takes on welfare policy. Washington, DC: Urban Institute.
18.
Horwitz, S., and Kerker, B. (2001). Impediments to employment under welfare reform: The importance of physical health and psychosocial characteristics. Women-Health, 32(1-2), 191-117.
19.
Kneipp, S. (2000). The health of women in transition from welfare to employment. Western Journal of Nursing Research, 22(6), 656-674.
20.
Knitzer, J., Yoshikawa, H., Cauthen, N., and Aber, J. (2000). Welfare reform, family support, and child development: Perspectives from policy analysis and developmental psychopathology. Development and Psychopathology, 12(4), 619-632.
21.
Loprest, P. (1999). Families who left welfare: Who are they and how are they doing? Assessing the new federalism: An Urban Institute program to assess changing social policies. Washington, DC: Urban Institute.
22.
Loprest, P. (2002). Who returns to welfare? Retrieved April 20, 2005, from http://www.urban.org/UploadedPDF/310548_B49.pdf.
23.
McDowell, I., and Newell, C. (1996). Measuring health: A guide to rating scales and questionnaires (2nd ed.). New York: Oxford University Press.
24.
Meyer, D., and Cancian, M. (1998, May). Economic well-being following an exit from aid to families with dependent children. Journal of Marriage and the Family, 60, 479-492.
25.
Meyer, D., and Cancian, M. (1999). Ten years later: Economic well-being among those who left welfare. Madison: University of Wisconsin, Institute for Research on Poverty.
26.
Miles, M., and Huberman, M. (1994). Qualitative data analysis (2nd ed.). Thousand Oaks, CA: Sage.
27.
Moffitt, R., and Cherlin, A. (2000). Disadvantage among families remaining on welfare. Chicago: Northwestern University/University of Chicago, Joint Center for Poverty Research.
28.
Pavetti, L., and Ace, G. (2001). Moving up, moving out, or going nowhere? A study of the employment patterns of young women and the implications for welfare mothers. Journal of Policy Analysis and Management, 20(4), 721-736.
29.
Polit, D., and Hungler, B. (1998). Nursing research: Principles and methods (6th ed.). Philadelphia: Lippcott Williams-Wilkins.
30.
Ragin, C. (1999). The distinctiveness of case-oriented research. Health Services Research, 34(5 Pt 2), 1137-1151.
31.
Raphael, J. (2002). Keeping battered women safe during welfare reform: New challenges. Journal of the American Medical Women’s Association, 57(1), 32-35.
32.
Richards, T., and Richards, L. (2003). The way ahead in qualitative computing. Journal of Modern Applied Statistical Methods, 2(1), 16-26.
33.
Romero, D., Chavkin, W., Wise, P., Smith, L., and Wood, P. (2002). Welfare to work? Impact of maternal health on employment. American Journal of Public Health, 92(9), 1462-1468.
34.
Smith, L., Romero, D., Wood, P., Wampler, N., Chavkin, W., and Wise, P. (2002). Employment barriers among welfare recipients and applicants with chronically ill children. American Journal of Public Health, 92(9), 1453-1457.
35.
Sweeney, E. (2000). Recent studies indicate that many parents who are current or former welfare recipients have disabilities or other medical conditions. Washington, DC: Center on Budget and Policy Priorities.
36.
U.S. Department of Health and Human Services. (USDHHS). (2000). Healthy people 2010 conference edition, in two volumes. Washington, DC: Author.
37.
U.S. Department of Health and Human Services. (USDHHS). (2002). Indicators of welfare dependence annual report to Congress, 2002. Retrieved January 17, 2004, from http://aspe.hhs.gov/hsp/indicators02.
38.
U.S. Department of Health Education and Welfare. (USDHEW). (1977). A concurrent validational study of the NCHS General Well-Being Schedule (No. HRA 78-1347). Washington, DC: Author.
39.
U.S. General Accounting Office. (GAO). (1999). Welfare reform: Information on former recipient status. Report to the chairman, committee on finance, U.S. Senate, and the chairman, subcommittee on human resources, committee on ways and means, House of Representatives (GOA/HEHS-99-48). Washington, DC: Author.
40.
Williams, D. (1999). Race, socioeconomic status, and health: The added effects of racism and discrimination. Annals of the New York Academy of Sciences, 896, 173-188.
41.
Williams, D. (2002). Racial/ethnic variations in women’s health: The social embeddedness of health. American Journal of Public Health, 92(4), 588-597.
42.
Wood, P., Smith, L., Romero, D., Bradshaw, P., Wise, P., and Chavkin, W. (2002). Relationships between welfare status, health insurance status, and health and medical care among children with asthma. American Journal of Public Health, 9(9), 1446-1452.
