Welfare Reform and the Health of Low-Income Single Mothers: The Impact of Policies Under the Personal Responsibility Work Opportunities and Reconciliation Act (PRWORA)

More than twenty years ago, President Clinton (D) signed the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996, effectively “ending welfare as we know it.” The impacts of the policy change it ushered in are still contested in the literature. After 20 years of implementation, it is more critical than ever to understand the impact of TANF on the families it was meant to help, especially because the policies of welfare reform (e.g., work requirements) are actively being exported to other important social policies such as Medicaid. This study contributes to the small body of literature on the impact of welfare reform on health. This study utilizes a consumption-based approach combined with the concept of time poverty to examine the impact of the PRWORA on the health of low-income single mothers. It exploits state-level variation in TANF policies to investigate the relationship between TANF policies and healthy eating behaviors using three secondary datasets. The data is analyzed using regression modeling techniques. The study findings suggest that less strict TANF policies are associated with higher time use related to “healthy” food behaviors such as grocery shopping and cooking at home. Among families receiving TANF benefits, families living in states with the strictest policies spend significantly more on “unhealthy” eating (e.g., eating out) compared with families living in states with the least strict policies. State TANF policies could do much more to support the self-sufficiency of poor families through supporting their health. This study provides some evidence that polices in state TANF programs may be resulting in a lack of time resources that negatively impact the time that single mothers are able to spend on “healthy” food behaviors such as grocery shopping and cooking at home. With more limited non-work time than before welfare reform, these policies may result in mothers spending more time and money on “unhealthy” foods that can meet limited time and money budgets