Welfare reform and infant health: The impact of mandatory maternal employment

Nearly 30 million American children – almost 40 percent of all Americans under 18 – live in or near poverty. Due to their poverty, these children face an increased risk of disease and death both in childhood and later in life. It is vital to the health of children and the future of our nation that we develop public policies that effectively address child poverty and its adverse effects on health.

The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), or “Welfare Reform,” is the most significant welfare policy in recent history, affecting both child poverty and children's health. PRWORA's hallmark was the implementation of “workfare,” explicitly requiring that welfare recipients – mostly mothers – work to receive benefits. Although many factors contribute to maternal employment's impact on children's well-being, the most influential are the number of hours worked, child's age, and quality of child care. Under PRWORA, states have unprecedented discretion in creating their welfare programs, such as defining work requirements, sanctions for non-compliance, and possible exemptions for mothers of young children.

This research will determine whether there is a relationship between these state “welfare” policies and infant health. Using extant data sources, appropriate multivariate analysis will be performed, with independent variables being state policies regarding maternal employment and dependent variables being state-level indicators of infant health status and health care utilization. Results are expected to identify the aspects of PRWORA that have affected infant health. The findings of this research can inform the policymaking process for PRWORA reauthorization.