The health status of women and their children is a key factor influencing whether single mothers moving off welfare can remain employed, according to a study by researchers at the School of Public Health (SPH). Having a health limitation increased a woman’s probability of job loss by 57 percent, while having a child with a health limitation increased the risk by 33 percent. The study appears in the Winter 2002 issue of the Journal of the American Medical Women’s Association, http://www.jamwa.org.
Dramatic changes in welfare policy in the United States have made many single mothers living in poverty rely on wages alone to care for their families where once they may have received income support from Aid to Families with Dependent Children (AFDC). This program was replaced under the 1996 welfare reform act with Temporary Assistance to Needy Families (TANF), which sets a five-year lifetime limit on income support to poor single parents and requires that they enter the workforce after 24 months or less of receiving government benefits.
“Because poor women are now dependent on earned income for their families’ economic well-being,” the researchers wrote, “it is crucial to understand what prevents them from holding on to the jobs they get.”
Previous studies have identified numerous factors influencing job loss including child care problems, low pay relative to expenses, lack of work experience, family problems such as alcohol and drug use, mental health problems, and conflict with or abuse by partners or family members.
This latest study, by Alison Earle, an instructor, and S. Jody Heymann, an associate professor, both in the Department of Health and Social Behavior at SPH, quantifies the effect of health problems on job loss and finds that except for the birth of a child, health is the most important predictor of job loss. The researchers drew their data from the National Longitudinal Survey of Youth, studying the two-decade histories of 783 women who had previously been on welfare. The impact of family health problems on job loss held true even while controlling for many factors including years of education, basic skills, race, age, region, urban residence, marital status, number of children, and local economic conditions.
A “health condition” was considered to be a chronic health problem such as a physical disability, asthma, diabetes, etc. Children with such health conditions have more school absences than their peers, require frequent medical appointments, and need to have medications and treatments administered by parents, requiring time off from work. It has been estimated that some 37 percent of mothers who had been on AFDC were caring for at least one child with a chronic health condition, compared to 21 percent of other mothers.
“Poor single mothers trying to meet work responsibilities while simultaneously caring for their own or their children’s health condition face a difficult challenge,” said Earle. “Job loss is a real risk whether because former welfare recipients lack paid leave but must take time off to care for a child with asthma, or because the lack of appropriate workplace accommodations makes it difficult to complete job tasks.”
What would help these women stay employed? The researchers’ previous studies have shown the importance of paid leave in the ability to care for children’s health needs, but poor families and those leaving welfare for work are frequently in jobs without fringe benefits and are less likely to have paid leave or flexibility than other families. “Policies that increase the availability of paid leave and schedule flexibility are needed,” the authors wrote.
“If poverty policy in the United States is to remain based on work mandates, then at the core of helping families exit poverty will be ensuring that parents who leave welfare for work can keep the jobs they find,” said Heymann. “This study makes it clear that those currently at highest risk of losing their jobs and landing in poverty are the very families with the greatest needs: families in which mothers and children have health problems or chronic conditions.”
For more information on families and work issues, visit http://www.hsph.harvard.edu/globalworkingfamilies.