Disabilities Among TANF Recipients: Evidence from the NHIS

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Abstract

This project uses data from the 2005/2006 National Health Interview Survey to provide a profile of the prevalence of different types of disability and employment among TANF recipients. We find that prevalence of disability varies widely depending on the specific measure used. Using narrow and broad composite disability measures, anywhere from 10 to 40 percent of TANF recipients have a disability and almost one-fifth have a family member with a disability. Disability prevalence among Food Stamp recipients is similar to TANF but low-income mothers have lower prevalence on almost all measures. Employment among TANF recipients with disabilities is considerably lower than among recipients without disabilities.

Introduction

Since the passage of welfare reform in 1996, the focus on moving TANF recipients into the labor force has led to increased study of recipients who have significant challenges that can impede work, including disabilities and serious health problems. Changes to regulations in the Deficit Reduction Act (DRA) of 2005 resulted in most states needing to engage more TANF recipients in work and exploring ways to engage these recipients. The recent recession may leave many states struggling to decide where to dedicate limited resources and how to meet the work participation requirements. Understanding the prevalence of disability among TANF recipients and other at-risk low-income populations at the time of reauthorization provides a baseline for analyzing subsequent changes. TANF administrators and policymakers at all levels of government can benefit from having information on disabilities among TANF recipients and employment among those with disabilities.

This report uses information from the National Health Interview Survey (NHIS) in 2005 and 2006—the years when DRA was passed and first being implemented - to provide a snapshot of the different types of disabilities among TANF recipients, how disability prevalence among TANF recipients compares to other groups, and employment rates among TANF recipients with disabilities. The report presents this information in straightforward tables and charts with bullets highlighting the most important findings. Before presenting the findings, we give a short background on what other studies have found and a section outlining our data, methods, and definitions. A more complete description of these can be found in the Appendix.

Prior Studies

Data from the 2002 NHIS show that 16.7 percent of the population ages 25 through 61 reports some measure of disability—defined broadly according to World Health Organization (WHO) classifications (Harris, Hendershot, and Stapleton 2005). As a group, people with disabilities are significantly less likely to work. While 88.3 percent of the population without disabilities report they worked at least sometime in the previous year, the comparable figure for people with disabilities was 57.9 percent (Harris et al, 2005).

A number of studies have examined the prevalence of disabilities among TANF recipients. An early study done at the time of welfare reform compared results on different measures of disability among AFDC recipients and their children using the NHIS, the Survey of Income and Program Participation (SIPP), and the National Longitudinal Survey of Youth (NLSY) and found that almost 30 percent of families receiving TANF had an adult or child with some level of functional limitation (Loprest and Acs 1996). A series of state and local studies funded by ASPE found consistently high percentages of recipients with mental and physical health problems (over 20 percent in each category) and that physical health was significantly related to a lower probability of work (Hauan and Douglas 2004). Polit, London, and Martinez (2001) also found high prevalence rates of a wide variety of health problems among welfare recipients, former recipients, and their children in large urban areas. They also found that women with multiple health problems were more likely to be sanctioned and less likely to be working.

A handful of more recent studies have used national-level data to examine health and disability among welfare recipients. Using the National Survey of America's Families (NSAF), Zedlewski (2003) and Loprest and Zedlewski (2006) showed high prevalence of work limiting disabilities and mental health problems among recipients and former recipients, ranging from 20 to 28 percent in 2002. The latter study also showed that the prevalence of these problems was significantly higher among current and former recipients than among low-income mothers who had never been on TANF. Acs and Loprest (2007) provided the most recent information on disability among TANF recipients using data from three waves of the NSAF, the 2001 Survey of Income and Program Participation (SIPP), and the 2000 and 2005 Current Population Survey (CPS). This research examined the prevalence of having a work-limiting condition and a child receiving disability benefits and suggests an increase in the prevalence of adult disability among current and former recipients since TANF was implemented. However, the measures of health and disability available in these data are limited.

The prevalence of disability and health problems among TANF recipients provides context for the potential size of the caseload that may need specialized resources, supports, case management, or accommodations. However, the relationship of these problems to work ability is extremely important in understanding how difficult it may be to move these recipients into work. Past research shows that among TANF recipients, having a health condition that limits work is associated with significantly lower likelihood of employment (Loprest and Zedlewski 2006). Research on the relationship of mental health problems to employment for TANF recipients is more mixed, depending on whether other health problems are also considered (Hauan and Douglas 2004; Loprest and Zedlewski 2006).

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