Penn State Intercom......November
Physical, mental illnesses
hinder low-income families
By Vicki Fong
In a study of 254 low-income families in three U.S. cities, 52 percent
report concurrent physical and mental health problems in both the primary
caregiver and at least one of the children in the household. In addition,
the separation of welfare assistance, Medicaid and health insurance programs
have created major challenges for recipients to obtain and keep a lasting
job a key goal of welfare reform, researchers said.
physical and mental health problems of these adults and children are substantial
and significantly hinder a familys attempts to transition from welfare
to permanent work and economic security, said co-author Linda Burton,
professor of human development and family studies and sociology. Our
data suggest that the health problems of parents and children are integrally
linked and solutions developed by state and federal policymakers should
comprehensively address both economic and health issues of families.
ethnographic study by Burton; Debra Skinner, research scientist, University
of North Carolina, Chapel Hill; Stephen Matthews, senior research associate
in social sciences at Penn State; and William Lachicotte, UNC-Chapel Hill;
is part of a larger ongoing project, Welfare, Children and Families:
A Three-City Study, where researchers at eight universities are
monitoring the consequences of welfare reform on the lives of 2,400 families
in Boston, Chicago and San Antonio.
Ethnographic research teams observed families day-to-day activities
and the influences impacting their interactions with school, work, family
and government and health-care agencies. Forty-nine percent were receiving
welfare assistance benefits; of that subgroup, 16 percent were working,
following welfare work requirements. The other 51 percent not receiving
welfare were working poor or unemployed.
Approximately 83 percent of the caregivers usually a biological
mother were 39 years old or younger; and nearly all had at least
one child 2 to 4 years of age. For primary caregivers, common physical
health conditions included diabetes, heart disease, severe obesity and
arthritis accompanied by mental health concerns such as depression, anxiety
or stress. For children, the researchers also found a range of serious
conditions such as severe chronic asthma, seizures or lead poisoning coupled
with depression, autism or attention deficit hyperactivity disorder, for
The fact that many of these caregivers face health problems usually
associated with older, frail individuals, is very troubling, Burton
noted. Also, we found that most of these caregivers tended to neglect
their own health needs to meet the economic and health-care needs of their
children and extended family.
The 254 families in the study included 42 families selected specifically
because they had children with moderate to severe disabilities. Co-author
Skinner, who directed the disability component, found similar challenges
with 83 percent reporting concurrent physical and mental health problems
in both the primary caregiver and at least one child.
The researchers also studied how all the families coped with seeking employment,
fulfilling welfare work requirements and trying to maintain their familys
health. Caregivers worked despite having serious health problems, but
frequently, they reported having lost or resigned from jobs because of
Insurance coverage was uneven across the non-disability families with
40 percent fully insured by Medicaid, private insurance or some combination
of the two; 60 percent were partially or uninsured. Of the disability
families, 74 percent were fully insured and 26 percent were partially
While Medicaid is working for many people, there are gaps in coverage
and access to services, the researchers said. Complicating factors affecting
private and public insurance coverage included grandparents without legal
custody of the children; caregivers working low-wage jobs with no health
benefits; caregivers inability to pay deductible and co-insurance
costs; and job schedules and transportation difficulties when traveling
to appropriate offices to apply for Medicaid or other types of health
There is no single reason for why families are failing to receive
the proper assistance, Burton and Skinner noted. Its
the convergence of all these forces that create unworkable situations
for families. These early findings highlight several key points that should
be considered in the current welfare reform reauthorization debate and
any further reforms in welfare assistance, Medicaid and employee health
Full reports of Welfare, Children and Families: A Three-City Study
are posted at http://www.jhu.edu/~welfare/.
Vicki Fong can be reached at vyf1@.psu.edu.
Labels do not
Labels listing energy density -- the number of calories per ounce -- do not encourage overeating the way "low fat" labels are suspected of doing, a University study says.
In the study, 40 normal weight women ate the same amount of food when their meals differed in calories by as much as 29 percent -- even when they were given la-bels that told them there were fewer calor-ies per portion. Tanja Kral, who conducted the study as her master's thesis, said, "Some studies have shown that people take larger portions of foods labeled 'low fat' using the label as a license to eat more. This study shows that energy density labels are unlikely to undermine the benefits of of-fering foods with fewer calories per ounce."
Kral conducted the study under the direction of Barbara Rolls, who holds the Guthrie chair of nutrition in the College of Health and Human Development.
Rolls said, "This tendency of people to take the same size serving of less energy-dense foods, even when they know the portion contains fewer calories, offers food manufacturers and restaurants a way to de-crease the fat and calories in their products, making them healthier and satisfying."
In the study, 40 healthy, normal weight women ages 18 to 32, ate breakfast, lunch and dinner in the University's Laboratory for the Study of Human Ingestive Behavior on three days each a week apart. Analysis showed that the pattern of food intake across the different levels of energy density was similar in the two groups when nutrition information was provided and when it was not.
Grant to enable study
of union structures
The organization of union locals may influence the way health-care workers view their unions, according to a University researcher.
The National Science Foundation awarded Paul Durrenberger, professor of anthropology, a grant to investigate how the structure of union organization, whether it is top-down or participatory, affects the way union members think and feel about their unions. The two-year grant is for about $200,000.
Durrenberger will investigate locals of health-care unions in Chicago and Pennsylvania to see how the organizational structures influence patterns of thought among union members.
"The findings will be important for all kinds of organizations, including management organization of work teams and quality circles, not just unions, because it will show us how organization affects how people think," the researcher said.