The 130th Annual Meeting of APHA

Abstract #39206

Susmita Pati, MD MPH¹, Diana Romero, MA PhD², and Wendy Chavkin, MD, MPH². (1) Divisions of General Pediatrics & General Medicine, Columbia University, 622 West 168th Street, PH 9 East, Room 105, New York, NY 10032, 212-305-5096, sp293@columbia.edu, (2) Department of Population and Family Health, Columbia University, 60 Haven Avenue, B-2, New York, NY 10032

Objective: To evaluate the association between welfare status and enrollment in Medicaid and Food Stamps programs among underserved populations in New York City.

Methods: Public assistance, Medicaid, and Food Stamps enrollment data were obtained from the Human Resources Administration in New York City. Designation of medically underserved areas was obtained from the Department of Health and Human Services. Percent change was calculated for different time periods based on available data. Percent change in Temporary Assistance to Needy Families (TANF) and Medicaid enrollment is reported for individuals for three time periods: 1994-1996, 1996-1998, and 1998-2001. Percent change in Food Stamps enrollment is reported for households for two time periods: 1996-1998 and 1998-2001.

Results: From 1994 to 2001, TANF enrollment declined by 62% and Medicaid enrollment increased by 103% in the Washington Heights/Inwood (WH/I) community district (CD), a low income, ethnic minority, medically underserved population. From 1996 to 2001, Food Stamps enrollment decreased by 22% in the WH/I community. From 1996-1998, there was a deceleration in Medicaid enrollment followed by doubling of enrollment rates from 1998-2001. Similar trends were found in Central Harlem and East Harlem, two other underserved CDs.

Conclusions: The dramatic declines in TANF enrollment have been accompanied by decreases in Food Stamps enrollment. Large increases in Medicaid enrollment indicate a persistent, growing need for health insurance in underserved populations in New York City. In the aftermath of the attacks of September 11th and the crash of Flight 587, policymakers should consider revising policies that limit benefits to needy families.

Learning Objectives: At the conclusion of the session, the participant will be able to

• Describe the Personal Responsibility Work Opportunity and Reconciliation Act (PRWORA) of 1996 and its effects on enrollment trends in health insurance and food stamps.
• Discuss the impact of these policy changes on underserved populations.
• Develop recommendations for congressional reauthorization of the PRWORA in 2002 to benefit underserved populations.

Keywords: Welfare Reform, Maternal and Child Health

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.