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Asthma, children and welfare reform

Asthma, children and welfare reform. March 13, 2003 Deborah Schlick and Rahel Tekle, Ramsey County Human Services. Welfare reform and serious health problems:. Of 8,000 families on MFIP in Ramsey County, at least 2200 have a severely disabled family member

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Asthma, children and welfare reform

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  1. Asthma, children and welfare reform March 13, 2003 Deborah Schlick and Rahel Tekle, Ramsey County Human Services

  2. Welfare reform and serious health problems: • Of 8,000 families on MFIP in Ramsey County, at least 2200 have a severely disabled family member • One national study found that 41% of working mothers who had been on welfare had at least one child with a chronic health condition J. Heymann et al, Work Family Issues and Low Income Families, Summer 2002

  3. Some national studies indicate that asthma rates are higher in children on welfare than in the general population

  4. 20-25% of families on welfare include a someone with a disability About 45% of all these disabilities are respiratory diseases, in particular asthma Expensive Children in Poor Families, Meyers, et. Al, Public Policy Institute of California Lukemeyer et al, 2000.

  5. 14% of working mothers who had received welfare for more than 2 years had a child with asthma vs. 7% of mothers who had never been on welfare Jody Heyman et al, Work Family Issues and Low Income Families, 2002

  6. Of the 187 children living at home in a study of very low income working families in 3 cities: 23% have diagnosed asthma Keeping Jobs and Raising Families in Low Income America, Across the Boundaries Project, Radcliffe Public Policy Center and 9 to 5, 2002

  7. How welfare reform impacts asthma in children: • Parents leaving welfare are likely to be in low paying jobswithout benefits, like health insurance or sick leave • Parents on welfare tend to use informal and changing child care arrangements

  8. Mothers who had been on welfare were: more likely to be caring for at least 1 child with a chronic condition (37% vs. 21%) yet were less likely to have sick leave (36% vs. 20%) SJ Heyman, American Journal of Public Health, v.89,#49

  9. How asthma in children can impact welfare reform: • Parents with children with asthma are more likely to miss work and therefore lose jobs • Parents are more likely to have difficulty finding child care they can be comfortable with

  10. Some basic information about children on MFIP in Ramsey County

  11. Ages of children Receiving Cash Assistance in Ramsey County as of October, 2002 n=22041

  12. Children Receiving Cash Assistance in Ramsey County by Race as of October 2002 n=22041

  13. Where in Ramsey County do Children on MFIP Live?As of October 2002 n= 22138

  14. Three groups of families on MFIP • Families who use welfare for a short period of time (3 years or less) and move, usually into low wage jobs • Families who reach time limits (set at five years by federal and state policy) • Families where only the child is on MFIP, because the parent is disabled or no longer has custody

  15. Percent of Children, 0 - 47 MFIP Months Used as of October, 2002 in Ramsey County by Race n=17,124

  16. What we have learned about families who reach the time limits on welfare

  17. Parents who stay on welfare a long time are very likely to have multiple and complex challenges -- including mental illness, active domestic violence, learning impairments, and major health problems

  18. Reasons people can stay on MFIP longer than 5 years: • Significant illness -- for the parent or a family member • “Hard to employ” diagnosis -- low IQ, learning disabilities, domestic violence, serious mental illness • Working 25-30 hours a week but not earning enough to get off

  19. Of the 900 Ramsey County families who reached time limits by December 2002, 778 received extensions

  20. Reasons MFIP has been extended for parentsas of December 2002

  21. More than 5000 children are in families reaching or nearing time limits in Ramsey County

  22. For almost 2000 families only the children are on MFIP – in more than 1300 of these families the parent is disabled

  23. Ramsey MFIP Children in MA HMOs as of Fall, 2002

  24. The implications of this information: Welfare reform cannot succeed if it does not address realities often not tied to training and work experience – such as whether a child’s chronic health problem needs to be addressed if her mother can sustain employment

  25. The implications of this information: To reach some of the children most at risk for poor asthma outcomes the health care system is going to have engage in non-medical strategies to improve children’s health

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