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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Lauren A. Smith, MD, MPH1, Diana Romero, MPhil, MA2, Pamela R. Wood, MD3, Nina S. Wampler, MPH4, Wendy Chavkin, MD, MPH2, and Paul Wise, MD, MPH5. (1) Boston Medical Center, Dowling 3 South, Dept of Pediatrics, One Boston Medical Center Place, Boston, MA 02118, 617-414-7911, lauren.smith@bmc.org., (2) Department of Population and Family Health, Columbia University, 60 Haven Avenue, B-2, New York, NY 10032, (3) University of Texas Health Science Center, 7703 Floyd Curl Dr., San Antonio, TX 78229-3900, (4) Epidemiology and Biostatistics Department, Boston University School of Public Health, 715 Albany Street, Talbot 3, Boston, MA 02118-2526, (5) Boston Medical Center, Maternity 4, Dept of Pediatrics, One Boston Medical Center Place, Boston, MA 02118
Objective: To evaluate impact of chronic child illness on parental employment among current, former and non-welfare recipients.
Methods: Study of 405 primary caretakers of chronically ill children, age 2-12 years, presenting to clinical sites and welfare offices in San Antonio, TX. Data collected on child health care utilization (HCU) (3 or more ED visits or 2 or more hospitalizations), illness severity (Rosier asthma score), parental employment and welfare status [current recipients (CR); former recipients (FR); applied/denied (AD); applied/pending (AP); non-recipients (NR)].
Results: The children of CR and FR were more likely to have high HCU (CR 31.7 %, FR 27.5 %, AD 17.0 %, AP 19.0 %, NR 17.7 %, p=0.06). CR, FR, and applicants were more likely to report that child illness adversely affected employment (CR 70.6 %, FR 81.7 %, AD 87.8%, AP 80.6%, NR 66.1%, p<0.01). Respondents with high child HCU were more likely to be unemployed (65.5%) compared to those with lower HCU (55.6%), p=0.06. Missing work due to child illness varied by welfare status (CR 60.5%, FR 79.6%, AD 80.0 %, AP 73.5 %, NR 61.0 %, p<0.01). In regression analyses, controlling for demographic factors, CR, FR and AP welfare statuses and high child HCU were predictors of unemployment. High child HCU was not associated with missed work. Among asthmatics (N=367), in addition to welfare status, high asthma severity scores were associated with missed work (OR 4.6, 95% CI 2.0,10.3).
Conclusions: Welfare recipients/applicants with chronically ill children face substantial barriers to employment, including high child health care utilization and missed work. Their special employment needs should be addressed during welfare reform's reauthorization in 2002.
Learning Objectives: At the conclusion of the session, the participant will be able to
Keywords: Welfare Reform, Children's Health
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.