The 130th Annual Meeting of APHA

Abstract #40687

Shawn M. Kneipp, PhD, ARNP, College of Nursing, University of Florida, PO Box 100187, Gainesville, FL 32610-0187, 352-392-9207, skneipp@nursing.ufl.edu

Changes in the 1996 welfare reform legislation now require women become employed to support themselves and their children. Several studies have documented that the extensive mental and physical health problems among women receiving Temporary Assistance for Needy Families (TANF, or "welfare") is severely hampering their ability to secure employment. As a result, there is increasing attention being given to integrating healthcare services into welfare-to-work programs. Currently, there is wide variation in how healthcare services in such programs are being implemented, and nurses are rarely mentioned as recommended providers of these services in government and other research-related reports. Public health nurses, at entry and advanced practice levels, however, are well-suited to improve access to primary healthcare and case-management services for disadvantaged women by partnering with TANF programs at the local level. Advocating for meeting the health needs of women in both individual and political terms is one clearly defined role of public health nurses who may increasingly be providing services within the context of welfare reform. Caution must be taken, however, to ensure the role of patient advocate is not superceded by other aspects of welfare-to-work programs, such as sanctioning practices (reductions in cash income or food stamps) that may be imposed when women are noncompliant with program requirements. This paper presents evidence of the need for nursing to become increasingly involved in welfare-to-work programs, and provides recommendations for reducing the likelihood that nursing objectives collide with, or become subservient to, the political objectives of welfare reform.

Learning Objectives:

• Describe prevalence differences of select health conditions among women receiving TANF compared to the general population.
• Describe current welfare reform policy implementation processes to address the health needs of the TANF population.
• Articulate why a continuum of nursing services integrated into welfare-to-work programs could improve access to healthcare services for the TANF population.
• Recognize how common welfare-to-work practices (e.g., sanctioning) may present challenges to or conflict with the patient advocacy role of public health nursing.

Keywords: Welfare Reform, Public Health Nursing

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.