HEALTH IMPLICATIONS OF WELFARE TO WORK FOR WOMEN

这项研究的目的是描述美国的福利政策可能如何影响健康，这涉及到1996年生活在150%贫困水平以下的就业妇女和那些接受公共援助的妇女在获得保健方面存在的障碍。就业、低收入妇女和接受公共援助的妇女都可能获得医疗补助，但获得医疗保健的障碍可能不同，特别是与就业有关的障碍。这项研究的三个具体目的是：1)描述低收入妇女在就业或AFDC收入方面在医疗保险覆盖范围、收入、健康状况、医疗保健利用模式、护理障碍和对获得医疗保健的满意度方面的差异；2)确定由拥有医疗补助覆盖范围的低收入就业妇女为户主的家庭在获得正常医疗保健方面是否遇到与就业因素或缺乏时间有关的更大障碍，以及3)确定低收入就业妇女在与就业和/或儿童护理有关的卫生保健障碍是否与较少的预防性护理有关，与接受AFDC的低收入失业妇女相比，更高的急诊科使用率、更高的住院率和更低的健康状况。将通过卫生保健政策和研究机构(AHCPR)对医疗支出小组调查(MEPS)数据进行二次分析，以实现本研究的目标。描述性统计将应用于数据，以检查就业、福利使用和健康结果变量之间的关系。在适当的情况下，将使用有意义的参数和非参数检验来确定是否可以进行总体推断。

The objective of this research is to describe how welfare policy in the United States may affect health with respect to barriers in accessing care for employed women living below 150 percent poverty level and those who were receiving public assistance in 1996. Both employed, low-income women and women receiving public assistance may be receiving Medicaid, but barriers in accessing care may be different, especially when related to employment. The three specific aims of this study are: 1) to describe differences in low-income women with respect to employment or AFDC receipt on health insurance coverage, income, health status, health care utilization patterns, barriers to care, and satisfaction with health care received, 2) to determine whether families headed by low-income employed women with Medicaid coverage experience greater barriers to a usual source of health care related to employment factors or lack of time than do families headed by women who are unemployed and covered by Medicaid, and, 3) to determine whether barriers to health care related to employment and/or child care in low-income employed women are associated with less preventive care, higher emergency department utilization rates, higher rates of hospital admissions, and lower perceived health status when compared to low-income unemployed women receiving AFDC. Secondary analyses of the Medical Expenditure Panel Survey (MEPS) data through the Agency for Health Care Policy and Research (AHCPR) will be used to meet the goals of this research. Descriptive statistics will be applied to the data to examine relationships between the employment, welfare use, and health outcome variables. Parametric and nonparametric tests of significance will be used when appropriate to determine whether population inferences can be made.