Welfare reform and women’s health: Challenges and opportunities to advance the public response to the health needs of poor women through monitoring and collaboration

In August 1996, the Personal Responsibility and Work Opportunity Reconciliation Act (P.L. 104-193; PRWORA) was signed into law ending a 60-year federal entitlement guaranteeing families a basic level of assistance during periods of economic hardship. Evaluations and policy studies examining the impact of welfare reform, as implemented through the program known as Temporary Assistance for Needy Families (T ANF), thus far have focused almost exclusively on economic and child health outcomes (Acs & Pavetti, 1997; Connolly, 2000; Haskins, Sawhill & Weaver, 200 I; Loprest, 1999; Chapin Hall Center, 2000; Cheri in et aI., 2001). The impact of welfare reform on women's health, a potentially important factor in achieving full economic self-sufficiency, has been a minor consideration in research studies with the exception of access to health insurance (Callahan, 1999; Chavkin, Romero & Wise, 2000; Danziger et aI., 1999; Garret & Holahan, 2000; Kneipp, 2000; Kramer, 2001; Winn & Lennon, 2000). Several aspects of the PRWORA have the potential to impact the health and well-being of women. These issues highlight areas of need and opportunity for state MCH Programs, offices on women's health, and welfare agencies to initiate new and/or strengthen current efforts on behalf of women and their families.