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APHA Scientific Session and Event Listing

Diana Romero, PhD, MA, Department of Population and Family Health, Columbia University, 60 Haven Avenue, B-2, New York, NY 10032, 212-304-5232, drr6@columbia.edu, Karuna Chibber, MHS, MA, UC Berkeley, 95 Monterey Blvd, San Francisco, CA 94131, and Christine Rinki, MPH, Northern Plains Tribal Epidemiology Center, 1770 Rand Road, Rapid City, SD 57702.

Objectives: To compare individual- and state-level differences in reproductive behaviors of welfare recipients and non-recipients, prior to and following welfare reform in 1996. Methods: We used data from the 1995 (n=10,847) and 2002 (n=7,643) NSFG, a nationally representative survey of women ages 15-45. Individual-level analyses compared poor and non-poor women with regard to contraceptive use, pregnancy, abortion, sterilization, and births, in 1995 and 2002. State-level analyses compared reproductive behaviors of welfare recipients in family-cap (FC) states and in non-family-cap (NFC) states, to determine if there were policy-related differences in reproductive behaviors. Results: In the individual-level analyses, there were no differences between poor and non-poor women except for abortion. In 1995, poor women were more likely to have had an abortion in the previous year than did non-poor women (2.8 vs. 1.3; p<.05); in 2002, the difference in abortion between poor and non-poor women increased (4.3 vs. 1.2; p<.001). After controlling for demographic, fertility-related, health-care utilization, and community-level factors in the multivariate analysis, welfare receipt persisted as a predictor of abortion in 1995 and 2002. In the state-level analyses, there were no significant differences among poor women in FC and NFC states in key reproductive outcomes. In 2002, there was one difference: women in NFC states were more likely to have received a method of contraception (36% vs. 27%; p<.05). Conclusions: The individual- and state-level findings question the validity of policy-makers' assumptions that poor women's reproductive behaviors differ dramatically from non-poor women and justify closer examination of the FC policy.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Recognize the utility and potential of the National Survey of Family Growth in analyzing reproductive health of women in general, and related to their welfare status specifically
• Identify at least five reproductive health outcome differences or similarities between welfare recipients and non-recipients
• Challenge assumptions concerning contraceptive use and child-bearing among poor women
• Critically evaluate policies that associate poverty with women’s reproductive behaviors

Keywords: Reproductive Health Research, Welfare Reform

Presenting author's disclosure statement:

Any relevant financial relationships? No