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7. Facing Reality
- Rutgers University Press
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163 Facing Reality Social and economic policies are health policy. When governments or other agencies make decisions that are going to have an impact on people’s lives, they need to understand the impact that could have on their health. —Kaplan et al. 2005 Social policies can have profound consequences for the health of the population .The passage of the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) in 1996 is often viewed as a defining moment in the history of social welfare in the United States and, as we have shown, affects health in varied ways. However, welfare reform policy does not exist in isolation. The political and fiscal attack on our welfare system has deep and historic roots that reflect American sentiment about poverty generally and poor women in particular. Americans tend to view public relief programs with suspicion, believing the programs discourage work incentives and motivation. Many people believe that families in need of welfare are lazy and content to live off the “public dole.” A culture of public resentment grew and pushed legislators more than a decade ago to implement radical welfare reforms, resulting in the erosion of one of our most vital national safety nets. With limited exceptions, lifetime Chapter 7 164 Just Don’t Get Sick welfare benefits were capped at a maximum of five years, and the majority of families were required to work after two years. Welfare reform has been deemed a monumental success, but what has happened to families in the aftermath of reforms? Welfare reform debates and associated measures of “success” are highly contentious. Between January 1998 and September 2000, the top fifty newspapers in the United States published 250 stories about welfare reform. A study examining these articles found that 52 percent of the articles portrayed welfare reform and the decline in caseloads as positive, or positive with caveats, and only 24 percent portrayed welfare reform as negative, or negative with caveats. The remaining 24 percent of stories were neutral and gave equal weight to the pros and cons of welfare reform (Schram and Soss 2001). News stories eschew investigative journalism in favor of presentations using government statistics, and the majority of these stories portray the TANF legislation as a resounding victory because the number of families on welfare has declined significantly. But if we dig deeper and investigate the lives of real families, we can find information that is largely unavailable from government statistics. The degree to which welfare reform is seen as a success is largely dependent on the specific goals of reform and what Joseph Gusfield (1981) called “public facts,” which are grand statements about social events which we do not or cannot experience personally (Gusfield 1981). Although some people have firsthand experience with poverty and welfare while raising children, many people do not. And even those who have experienced bouts of poverty or the receipt of public aid do not necessarily extrapolate their unique exposure to the general public. Instead, people must rely on the assessments of public officials, the media , and policy experts to help frame both the problem and the solution. In the case of welfare reform, the specific goals or markers of success have rested squarely on declining caseloads (rather than other markers, such as a reduction in poverty, or an increased number of poor children in early childhood education programs). Declining caseload as the sole indicator arose because during the period from the 1960s to 1990s increasing attention was given to socalled welfare dependency, intergenerational poverty, and long-term use. The resulting 1996 reform sought to address these issues, but did so in a way that ignored the sources of poverty, such as increasing income inequality, the erosion of the purchasing power of minimum wages, racial and sex discrimination in the workplace, and other forms of social injustice. Meanwhile, many researchers, policy experts, and “think tanks” warned against the potentially devastating effects of these reforms, pointing to the [52.90.50.252] Project MUSE (2024-03-29 00:45 GMT) Facing Reality 165 likelihood of increased hardship and poverty among families with children (Harris 1996; Sandefur 1996; Zedlewski et al. 1996). However, a growing consensus among social conservatives, moderates, and even some liberals solidi- fied in the mid-1990s that welfare “as we know it” must be revamped, and caseloads must be reduced. If the purpose is simply to move families off public aid, then welfare reform policies have clearly met their...