Lynne Kotranski, PhD¹, Francine Axler, MPH¹, and Abdul Beraima, PhD². (1) Research and Evaluation, Philadelphia Health Management Corporation, 260 South Broad Street, Philadelphia, PA 19102, (215) 985-2552, lynne@phmc.org, (2) Information Systems Division, Philadelphia Health Management Corporation, 260 S. Broad St., Phila, PA 19102

Much discussions about welfare reform efforts focus upon job readiness, job placement and childcare. However, the physical and emotional health of welfare recipients are important in understanding the factors impacting and impacted by these policy shifts. This paper examines the health characteristics of women receiving Medicaid benefits both before and after the implementation of TANF. Data for this paper were collected through a representative household health survey of 10,163 adults in Southeastern Pennsylvania, having a concentration of the state’s welfare recipients. The analysis focuses on women 18-64 residing in Philadelphia in 1998 and 2002. Information was collected on physical and emotional health indicators, health behaviors, and structural and other barriers to the receipt of health care. Welfare recipients were compared to women with private insurance and to the uninsured. In 2002, 43.8% women Medicaid recipients report themselves to be in fair/poor health and 40% have at least one chronic condition requiring ongoing care. These percentages increased from 1998. Forty percent report high levels of stress in their daily lives, similar to that reported in 1998 and 29.1% reported having a mental health problem such as anxiety or depression, a 40% increase from 1998. One out of eight (13%) experienced physical violence in the past year and 18% stayed home in the past month because of safety concerns. Lack of transportation continued to be the greatest structural barrier to the receipt of health care (37.8%). The implications of these findings for employment training and stability and needed services are discussed.

Learning Objectives:

• to assess the health characteristics of low income women;
• to understand some dimensions of the relationship between health and welfare policy; and
• discuss some programmatic and policy implications of findings.

Keywords: Urban Health, Health Care Access

Related Web page: www.phmc.org/chdb

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.