What's a mother to do? Welfare, work, and family

Family and medical leave act: unresolved issues

The United States' Family and Medical Leave Act (FMLA) of 1993 was an effort to provide national support for families attempting to balance the demands of the workplace and the need to care for a new child, one's own health, or an ill child, spouse, or parent. It is seriously limited, however, in terms of its accessibility for many workers. We briefly compare the FMLA to the substantially broader policies of Western European countries. We highlight its reported benefits to workers but document disparities in employees' use of the FMLA by gender, race, and income level. We evaluate whether employers' fears of higher costs were justified. We point out current challenges that may limit the FMLA further. We close by examining the range of alternative policies in effect at the state level and proposals that would address the current limitations of the FMLA and broaden its coverage.

Food insufficiency and the physical and mental health of low-income women

Poor women with children are disproportionately represented among the food insufficient. Recent research has linked food insufficiency with dietary deficiencies, but further research linking this problem to health and mental health problems is needed to inform health and social policy. We analyzed the relationship between food insufficiency and physical and mental health in a random sample of 724 single women who were welfare recipients in February, 1997. Food insufficiency was significantly associated with poor or fair self-rated health and physical limitations, and with respondents' meeting DSM-III-R criteria for recent major depression. Although the cross-sectional design of this study precludes causal inference, these findings add to a growing body of evidence that food insufficiency is associated with serious adverse physical and mental health consequences.

Keeping the unemployed healthy: the effect of means-tested and entitlement benefits in Britain, Germany, and the United States

OBJECTIVES

Although considerable evidence about the health effects of unemployment exists, little is known about the possible protective effects of various social interventions. This study examined the role that means-tested and entitlement programs could have in ameliorating the health impact of unemployment in Britain, Germany, and the United States.

METHODS

Logistic regression models were used to analyze panel data from Britain (1991-1993), Germany (1991-1993), and the United States (1985-1987) available in the Household Panel Comparability Project database. The analysis included 8,726 respondents from Britain, 11,086 from Germany, and 11,668 from the United States. The health-dependent variable used was a single measure of perceived health status.

RESULTS

Evidence was found of differences in perceived health status between groups of unemployed people characterized by the types of benefits they receive. When socioeconomic characteristics and previous health and employment status are controlled for, means-tested benefits do not seem sufficient to reduce the impact of unemployment on health.

CONCLUSIONS

Monitoring the possible health effects of changes in public assistance benefits should be given priority in the research and political agenda.

A nursing critique of US welfare system reform

In 1996, the Aid to Families with Dependent Children program was repealed, and the welfare system in the United States was changed. This article critiques, from a nursing perspective, US welfare system reform. It interrogates dominant ideologies about poverty, welfare, and waged labor; examines federal welfare reform legislation of the 1990s and its programmatic implementation at the state level; discusses global health and safety implications of welfare replacement initiatives; and challenges nurses to political and scholarly action.