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. 2014 Jul;18(5):1176-89.
doi: 10.1007/s10995-013-1348-0.

The influence of maternal health literacy and child's age on participation in social welfare programs

Susmita Pati  1 , Elizabeth Siewert, Angie T Wong, Suraj K Bhatt, Rose E Calixte, Avital Cnaan
Affiliations

The influence of maternal health literacy and child's age on participation in social welfare programs

Susmita Pati et al. Matern Child Health J. 2014 Jul.

Abstract

The objective of this study is to determine the influence of maternal health literacy and child's age on participation in social welfare programs benefiting children. In a longitudinal prospective cohort study of 560 Medicaid-eligible mother-infant dyads recruited in Philadelphia, maternal health literacy was assessed using the test of functional health literacy in adults (short version). Participation in social welfare programs [Temporary Assistance to Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP), Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), child care subsidy, and public housing] was self-reported at child's birth, and at the 6, 12, 18, 24 month follow-up interviews. Generalized estimating equations quantified the strength of maternal health literacy as an estimator of program participation. The mothers were primarily African-Americans (83%), single (87%), with multiple children (62%). Nearly 24% of the mothers had inadequate or marginal health literacy. Children whose mothers had inadequate health literacy were less likely to receive child care subsidy (adjusted OR = 0.54, 95% CI 0.34-0.85) than children whose mothers had adequate health literacy. Health literacy was not a significant predictor for TANF, SNAP, WIC or housing assistance. The predicted probability for participation in all programs decreased from birth to 24 months. Most notably, predicted WIC participation declined rapidly after age one. During the first 24 months, mothers with inadequate health literacy could benefit from simplified or facilitated child care subsidy application processes. Targeted outreach and enrollment efforts conducted by social welfare programs need to take into account the changing needs of families as children age.

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Conflict of interest statement

Financial conflict(s) of interest: None to disclose

Figures

Figure 1
Figure 1. Estimated probability for participation in public programs by maternal health literacy
Note: The graph presents estimated program participation based on the best fitting GEE model for single, African-American mothers with one child who are employed full time with $1000 monthly income, have more than high school education, are living alone, and do not receive SSI.
See this image and copyright information in PMC

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