4325.0: Tuesday, November 14, 2000 - 9:40 PM

Abstract #18284

Descriptive analysis of organizational and community health changes under welfare reform

Susan Burger, MSN, RN, University of North Carolina, Chapel Hill, NC, , N/A

The central research question which prompted this study was, "How have health-related organizations and community health changed during the first years of welfare reform policy implementation in Camden, Essex, and Hudson Counties, New Jersey"? A comparative, case study was designed to construct in-depth descriptions of these changes. The boundaries of who and what to include in these cases were directed by concepts of Milio's ecological framework. Data were obtained from semi-structured interviews with twenty informants representing eleven organizations in the three counties. Organizational and public documents were reviewed for additional data, and as a means of validating interview data. Throughout New Jersey welfare reform policy implementation, county welfare agencies made organizational changes that shifted their focus from supporting family well-being to encouraging work and work-related activities as a means to achieving independence from welfare. Welfare agencies that are most effective in reducing welfare rolls actually contribute to a more constraining socio-health climate by exacerbating an already increasing uninsured population. Large numbers of low-income and uninsured individuals could overwhelm existing safety net health care providers (public health departments and community health centers) thereby constraining their abilities to meet health care needs of these populations. Beyond responding to welfare reform policy with short term survival tactics, health-related organizations need to be proactive in the longer term reformulation of current welfare policy. Specifically, nursing leaders and other advocates of healthy welfare reform can frame reformulation of welfare policy as a problem in health insurance.

Learning Objectives: To examine how health-related organizations changed as a result of welfare reform. To describe changes in welfare within the state of NJ. To examine welfare policy as a problem in health insurance

Keywords: Welfare Reform, Research

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
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.

The 128th Annual Meeting of APHA