Effects of welfare and maternal work on recommended preventive care utilization among low-income children

Objectives: 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, andwe 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. Conclusion: The Temporary Assistance for Needy Families maternal work requirement may be a barrier to receiving recommended preventive pediatric health care.