Effects of welfare and maternal work on recommended preventive care utilization among low-income children.
OBJECTIVE
We examined how maternal work and welfare receipt are associated with children receiving recommended pediatric preventive care services.


METHODS
We identified American Academy of Pediatrics-recommended preventive care visits from medical records of children in the 1999-2004 Illinois Families Study: Child Well-Being. We used Illinois administrative data to identify whether mothers received welfare or worked during the period the visit was recommended, and we analyzed the child visit data using random-intercept logistic regressions that adjusted for child, maternal, and visit-specific characteristics.


RESULTS
The 485 children (95%) meeting inclusion criteria made 41% of their recommended visits. Children were 60% more likely (adjusted odds ratios [AOR` = 1.60; 95% confidence interval [CI] = 1.27, 2.01) to make recommended visits when mothers received welfare but did not work compared with when mothers did not receive welfare and did not work. Children were 25% less likely (AOR = 0.75; 95% CI = 0.60, 0.94) to make preventive care visits during periods when mothers received welfare and worked compared with welfare only periods.


CONCLUSIONS
The Temporary Assistance for Needy Families maternal work requirement may be a barrier to receiving recommended preventive pediatric health care.
Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Jane L
JL
Holl
Elissa H
EH
Oh
Joan
J
Yoo
Laura B
LB
Amsden
Min-Woong
MW
Sohn
D000328:Adult; D002675:Child, Preschool; D004651:Employment / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007087:Illinois / Q000453:epidemiology; D016015:Logistic Models; D008137:Longitudinal Studies; D009035:Mothers / Q000706:statistics & numerical data*; D011203:Poverty / Q000706:statistics & numerical data*; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D012946:Social Welfare / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D055815:Young Adult