The health of poor women under welfare reform

Abstract

Objectives: We compared the health of single mothers affected by welfare reform with the health of a nationally representative sample of women to document the prevalence of poor health as single mothers experience the effects of welfare reform. Methods: We compared risk factors and measures of health among women randomly sampled from the welfare rolls with similar data from a nationally representative sample of women. Results: Women in our welfare recipient sample had higher rates of elevated glycosylated hemoglobin (≥6%; prevalence ratio [PR]=4.87; 95% confidence interval [CI]=2.69, 7.04), hypertension (systole ≥140 or diastole ≥90; PR=2.36; 95% CI=1.47, 3.24), high body mass index (≥30; PR=1.78; 95% CI=1.49, 2.08), and high-density lipoprotein cholesterol (≤35 mg/dL; PR=1.91; 95% CI=1.17, 2.65); lower peak expiratory flow; and less physical functioning. Current smoking rates were higher (PR=1.85; 95% CI=1.50, 2.19) and smoking cessation rates were lower (PR=0.62; 95% CI=0.37, 0.86) than in the national sample. Conclusions: Current and former welfare recipients bear a substantial burden of illness. Further studies are necessary to interpret our findings of worsened health in the wake of welfare reform.