Lost in Appalachia: The Unexpected Impact of Welfare Reform on Older Women in Rural Communities

A primary goal of welfare reform was to overcome welfare dependency through the promotion of work and the setting of lifetime limits. While atf irst blush thisg oal may have appearedr easonablef or young recipients, it does not address the needs of older recipients, particularly women. Based on in-depth interviews with welfare recipients in four impoverished rural Appalachian counties over a four year time span (1999-2001; 2004), this paper evaluates the experiences of older women as they confront the changes brought on by welfare reform legislation. Findings suggest that impoverished older women in isolated rural communities experience multiple crises as they attempt to negotiate the new welfare system. As a result of spatial inequality, limited social capital, and the effects of ageism, they have tremendous difficulty meeting even their most basic needs

Does Welfare Reform Work in Rural America? A 7-Year Follow-up

Even before the advent of welfare reform, studies of low income working and welfare dependent groups showed that low wage working women are worse off than those who combine welfare with other income sources and that most used a wide variety of livelihood strategies. This is especially the case in poor rural settings where work is scarce and additional obstacles to employment such as lack of transportation and childcare are endemic. Data from a selfadministered survey of users of human service agency programs in four counties in a distressed region of Appalachian Ohio in 1999, 2001, and 2005, provide a comprehensive picture of livelihood strategies, including labor force participation, informal and self-provisioning practices, and use of government and private transfers early and late in the welfare reform process. We compare working and nonworking human service clients at all three time periods and across communities with different levels of capacity to implement welfare to work policies to determine how labor force participants differ from other recipients and whether they are better or worse off. The data demonstrate the problems in making ends meet for all respondents, regardless of employment status and county capacity in all three time periods. While county differences are minimal, workers are better off than nonworkers and more so by the third survey year. They employ a wide variety of livelihood strategies beyond work for wages. Nevertheless, they remain poor and vulnerable to numerous hardships. 1Suppor

Multiple Levels of Social Disadvantage and Links to Obesity in Adolescence and Young Adulthood

BACKGROUND The rise in adolescent obesity has become a public health concern, especially because of its impact on disadvantaged youth. This article examines the role of disadvantage at the family‐, peer‐, school‐, and neighborhood‐level, to determine which contexts are related to obesity in adolescence and young adulthood. METHODS We analyzed longitudinal data from Waves I (1994‐1995), II (1996), and III (2001‐2002) of the National Longitudinal Study of Adolescent Health, a nationally representative population‐based sample of adolescents in grades 7‐12 in 1995 who were followed into young adulthood. We assessed the relationship between obesity in adolescence and young adulthood, and disadvantage (measured by low parent education in adolescence) at the family‐, peer‐, school‐, and neighborhood‐level using multilevel logistic regression. RESULTS When all levels of disadvantage were modeled simultaneously, school‐level disadvantage was significantly associated with obesity in adolescence for males and females and family‐level disadvantage was significantly associated with obesity in young adulthood for females. CONCLUSIONS Schools may serve as a primary setting for obesity prevention efforts. Because obesity in adolescence tracks into adulthood, it is important to consider prevention efforts at this stage in the life course, in addition to early childhood, particularly among disadvantaged populations.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/96235/1/josh12009.pd

What Explains Divorced Women's Poorer Health? The Mediating Role of Health Insurance and Access to Health Care in a Rural I owan Sample

Economic restructuring in rural areas in recent decades has been accompanied by rising marital instability. To examine the implications of the increase in divorce for the health of rural women, we examine how marital status predicts adequacy of health insurance coverage and health care access, and whether these factors help to account for the documented association between divorce and later illness. Analyzing longitudinal data from a cohort of over 400 married and recently divorced rural I owan women, we decompose the total effect of divorce on physical illness a decade later using structural equation modeling. Divorced women are less likely to report adequate health insurance in the years following divorce, inhibiting their access to medical care and threatening their physical health. Full‐time employment acts as a buffer against insurance loss for divorced women. The growth of marital instability in rural areas has had significant ramifications for women's health; the decline of adequate health insurance coverage following divorce explains a component of the association between divorced status and poorer long‐term health outcomes.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/95231/1/ruso91.pd

Q methodology and rural research

Traditionally, rural scholarship has been limited in its methodological approach. This has begun to change in recent years as rural researchers have embraced a range of different methodological tools. The aim of this article is to contribute to greater methodological pluralism in rural sociology by introducing readers to a method of research that is rarely engaged in the field, that is, Q methodology. The article describes the defining features of the approach as well as providing examples of its application to argue that it is a method that offers particular opportunities and synergies for rural social science research

An argument against the focus on Community Resilience in Public Health

Background - It has been suggested that Public Health professionals focus on community resilience in tackling chronic problems, such as poverty and deprivation; is this approach useful? Discussion - Resilience is always i) of something ii) to something iii) to an endpoint, as in i) a rubber ball, ii) to a blunt force, iii) to its original shape. “Community resilience” might be: of a neighbourhood, to a flu pandemic, with the endpoint, to return to normality. In these two examples, the endpoint is as-you-were. This is unsuitable for some examples of resilience. A child that is resilient to an abusive upbringing has an endpoint of living a happy life despite that upbringing: this is an as-you-should-be endpoint. Similarly, a chronically deprived community cannot have the endpoint of returning to chronic deprivation: so what is its endpoint? Roughly, it is an as-you-should-be endpoint: to provide an environment for inhabitants to live well. Thus resilient communities will be those that do this in the face of challenges. How can they be identified? One method uses statistical outliers, neighbourhoods that do better than would be expected on a range of outcomes given a range of stressors. This method tells us that a neighbourhood is resilient but not why it is. In response, a number of researchers have attributed characteristics to resilient communities; however, these generally fail to distinguish characteristics of a good community from those of a resilient one. Making this distinction is difficult and we have not seen it successfully done; more importantly, it is arguably unnecessary. There already exist approaches in Public Health to assessing and developing communities faced with chronic problems, typically tied to notions such as Social Capital. Communityresilience to chronic problems, if it makes sense at all, is likely to be a property that emerges from the various assets in a community such as human capital, built capital and natural capital. Summary - Public Health professionals working with deprived neighbourhoods would be better to focus on what neighbourhoods have or could develop as social capital for living well, rather than on the vague and tangential notion of community resilience.</p

Linking mental and primary health care in rural areas

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44091/1/10488_2005_Article_BF02254827.pd