Welfare reform, fertility, and father involvement

Recognizing that most poor families are single-parent families, the federal welfare reform law of 1996 emphasized the responsibility of both parents to support their children. In addition to strengthening the child support enforcement system, the law included several provisions designed to decrease childbearing outside of marriage and to promote two-parent families. This article focuses on the important role that fathers play in children's lives and how public policies have affected childbearing and father involvement. Key observations are: Compared with children living with both biological parents, children in father-absent families often have fewer economic and socioemotional resources from their parents, and do not fare as well on many outcome measures. Efforts to reduce the rising number of father-absent families by focusing on preventing unwanted pregnancy among unmarried women, especially teen girls, have met with some success; those programs seeking to alter adolescents' life opportunities in addition to providing education or family planning services appear to hold the most promise. Efforts to encourage greater father involvement by focusing almost exclusively on increasing absent parents' child support payments reap only minimal benefits for poor children because their absent parents often have few resources and little incentive to make support payments. To date, efforts to increase the emotional involvement of unmarried fathers with their children have produced disappointing results, but new research suggests that such programs can make a difference when targeting fathers at the time of a child's birth. Many children spend some time living away from their fathers, deprived of the financial and emotional resources they can provide. Because of the importance of fathers to child well-being, the authors conclude that new directions in research and public policies are needed to encourage greater father involvement across the wide diversity of family arrangements in society today.

Disaster unemployment assistance program. Interim final rule; request for comments

The Employment and Training Administration (ETA) of the Department of Labor (Department) is issuing this interim final rule, effective upon publication, to clarify eligibility for disaster unemployment assistance (DUA) in the wake of the major disasters declared as a result of the terrorist attacks of September 11, 2001. To provide an opportunity for public participation in this emergency rulemaking, this interim final rule includes a post-publication comment period. The Department will publish a final rule after taking into account any comments that are received.

Welfare reform and the perinatal health and health care use of Latino women in California, New York City, and Texas

OBJECTIVES

This study analyzed changes in the financing of prenatal care and delivery, the use of prenatal care, and birth outcomes among foreign-born vs US-born Latino women following enactment of the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) in August 1996.

METHODS

We used a pre-post design with a comparison group. The sample consisted of resident Latinas in California, New York City, and Texas who delivered a live infant in 1995 or 1998.

RESULTS

The proportion of births to Latinas that initiated prenatal care in the first 4 months of pregnancy increased for all foreign-born Latinas in California, New York City, and Texas between 1995 and 1998 (P <.05). Except for non-Dominicans in New York City, there was no increase in the proportion of low- or very-low-birthweight births among foreign-born vs US-born Latinas in the 3 localities between 1995 and 1996.

CONCLUSIONS

There is little evidence from vital statistics in California, New York City, and Texas that PRWORA had any substantive impact on the perinatal health and health care utilization of foreign-born relative to US-born Latinas.

Post-Welfare employment and psychological well-being

Current public assistance policies are removing many recipients from the welfare rolls, regardless of their income level. This article examines the post-assistance well-being of a stratified probability sample of 426 "able-bodied" women and men who lost cash benefits when Michigan terminated its General Assistance program in 1991. The relationship of demographic, human capital, and psychological resource variables to employment status, depressive symptomatology and life satisfaction is examined utilizing two panels of survey data, collected approximately one and two years after the program ended. Findings demonstrate that personal mastery is related to employment status and risk of depression, and sense of burden is linked to both psychological outcomes, controlling for relevant demographic and human capital variables. Gender is related to risk of depression; however, its relation to employment is dependent on the presence of children in the household. Steady employment is positively associated with psychological well-being. Overall, the findings suggest that the majority of former recipients faced employment difficulties and psychological hardship, and that services should be targeted to subgroups of former recipients with particular risk factors.

Welfare reform and "ineligibles": issue of constitutionality and recent court rulings

In 1996 welfare legislation made lawful immigrants, with a few exemptions, categorically ineligible for most forms of public assistance. This legislation has led affected immigrants and their advocacy groups to file lawsuits to challenge the constitutionality of the Personal Responsibility and Work Opportunity Reconciliation Act. This article reviews recent court rulings that have upheld the act and examines court decisions in light of two constitutional principles (the Equal Protection and Supremacy clauses), which traditionally have been applied to the issue of aliens' eligibility for welfare benefits. The author finds inconsistent outcomes between federal and state legislation in the judicial review process. To resolve this inconsistency, the author suggests several policy changes in the distribution of welfare benefits concerning eligibility of lawful immigrants. The implications for social work practice are discussed.

Rhetoric and reality of work-based welfare reform

The argument presented in this article is that although work is one path toward improved well-being for poor families, a successful and humane social welfare policy must recognize and respond to its limitations. The prowork rhetoric surrounding current efforts to move women from welfare to work rests on at least three propositions: Work is the norm, work is good for families, and work leads to self-sufficiency. The article reviews empirical evidence on each of these propositions and concludes that many former welfare participants will earn low wages in unstable employment and will require a broad range of supports to move from welfare to self-sufficiency and improved family well-being.

Pockets of childhood poverty persisted despite a strong economy in the late 1990s: impact in special cases

Governmental and private agency reports provide varying views on childhood poverty levels during the final years of the 1990s. A review of these reports reveals that significant levels of childhood poverty continue, particularly in single parent households. The impact on children with special health care needs is considered.

The health and mental health of disabled substance abusers

In 1996 Congress terminated Supplemental Security Income (SSI) benefits to individuals disabled by substance abuse. Although most were expected to continue benefits under another disability category, 64% were not reclassified. This article examines data from a longitudinal study of individuals in Los Angeles County affected by the legislation. While poor physical health predicted both continued SSI benefits and receipt of public income assistance, many individuals reporting significant mental and physical health problems were not reclassified and did not receive public income assistance, raising concern for their welfare. Local safety nets may become increasingly important for this population.

Culture, class, and service delivery: the politics of welfare reform and an urban bioethics agenda

Culture and class remain contested terrains in policy narratives about the right of the urban poor to access health and social services delivery systems under welfare reform. An urban bioethics agenda is needed to address these dilemmas that have arisen in the context of PRWORA and had an impact on access to health and social services in the urban environment.^2;18 Such efforts, however, must address the intellectual framing of the urban poor, as well as the public policies that inscribe deterministic and stereotypical ideas about the poor alongside incomplete portraits of barriers to greater social and occupational mobility. The focus of social science researchers on the delineation of behavioral characteristics among an urban “underclass” in some instances further marginalizes and stigmatizes an already isolated urban poor. Even though Wilson, the Harvard sociologist who popularized the term “underclass” in his earlier research, has now largely disowned it, tales and stories a bound in the social policy and health literature. The media also commonly underscore perceptions that establish rumor as social science and promote stereotypes that the poor are lazy and unwilling to work. Wilson, who has analyzed contextual and neighborhood factors such as the migration of jobs to the suburbs, has also declared stance that is in opposition to those, such as New York University political science professor Lawrence Mead, who embrace a “culture of poverty” thesis and have set the tone for some welfare reform initiatives by arguing that behavior, and not joblessness, is the key, “My guess,” Mead stated after welfare reform was enacted in 1996, ”is that culture came first, and drove away the economy or the good jobs, rather than the other way around,” ^21(p3)These statements continue to have dramatic impacts on the stigmas attached to public programs by promoting the idea that those in spatially concentrated radical and ethnic groups in urban areas are not members of the working class. Such perceptions have also contributed to a belief that those who participate in publicly subsidized social welfare and health insurance programs do not work. Whether one accepts that the denial of health care to citizens and noncitizens in contemporary America derives in large part from the promotion of images of the poor as pathological, states have moved steadily to institute a variety of policies under welfare reform that continue to prescribe narrower eligibility criteria for access to service delivery systems. This is occurring as the US Congress hesitates to restore excluded populations, and there are reports of questionable practices targeted at those who are eligible based on current legislation. On several occasions, for example, the Civil Rights Division of the US Department of Health and Human Services has made inquiries (and issued sanctions) in cases for which state and local governments have discriminated against potential Medicaid and TANF applicants by ignoring regulations that stipulate that applications be delivered to applicants on request in a timely manner.³ While it is the explicit responsibility under welfare reform of the US Congress to pass legislation restoring eligibility to excluded populations, an urban bioethics agenda framed in a historical context has much to offer prevailing policy discourses. If, as political theorist Stone notes, a policy alternative is to be judged “by the company that it keeps,” then urban bioethicists can offer human rights paradigms and additional policy alternatives based an assessments of earlier historical experiences of stigmatization that embodied similar forms of evil.²³

The AIDS drug assistance programs and coverage of HIV-related medications

BACKGROUND

AIDS drug assistance programs (ADAPs) have been implemented in each state to facilitate access to medications for low-income, uninsured, and underinsured people with HIV disease. Policies for each ADAP differ, and these differences influence the access people with HIV have to medications.

OBJECTIVE

To compare the coverage of medications and sources of program funding for the state ADAPs.

DESIGN

A self-administered mailed survey, sent to administrators of the 50 state ADAPs and the District of Columbia ADAP in December 1998.

RESULTS

Forty-nine of the 51 ADAPs (96%) responded to the survey. Title II of the Ryan White Comprehensive AIDS Resources Emergency Act provided a large majority of the funding for the ADAPs, with a number of states also using state funds and/or Title I funds for their programs. The formularies of all ADAPs were nearly identical with respect to coverage of antiretrovirals, but differed in the number and types of other medications included. Some states limited access to medications through waiting lists, enrollment caps, and other policies. Sixteen ADAPs reported that the coverage of protease inhibitors resulted in an appropriation of state government funds to their ADAP, while eight states reported an ADAP budget shortfall. In general, ADAPs in poorer and more rural states included a fewer number of medications on their formularies.

CONCLUSIONS

Access to antiretrovirals and other medications is available through state ADAPs, but may be limited in some states due to waiting lists, controls on the enrollment of new beneficiaries, and policies on the number and types of medications beneficiaries may receive.

From relief to mutual obligation: welfare rationalities and unemployment in 20th-century Australia

Unemployment policy is currently informed by notions of labour force flexibility, workfare and mutual obligation. Things have not always been this way. Over this century there have been profound shifts in the way in which unemployment and government responsibilities have been conceptualized. Using the notion of ‘welfare rationalities’ to guide the discussion, this paper records the nature of these changes. Particular attention is paid to the ways in which economic objectives intersect with the social and moral-behavioural components of unemployment programmes. The changing nature of these factors is traced through three distinct welfare rationalities surrounding un/employment: relief, full employment and mutual obligation.