摘要：Objectives. Exposure to violence is a widespread problem among women who receive welfare benefits. Research has focused on partner violence among women with children on Temporary Assistance for Needy Families (TANF), ignoring low-income women without dependent children who are eligible for General Assistance (GA). Methods. We report findings from a survey of 1235 women seeking TANF (N=1095) and GA (N=140) throughout a California county. Results. Estimates of recent physical, sexual, and severe violence were high in both populations. However, the highest rates occurred among women without children seeking GA, suggesting that they are at higher risk for sexual violence and more severe forms of physical violence, especially from intimate partners. This increased risk is partly accounted for by the co-occurrence of other serious health and social problems. In multivariate analyses, past-year violence was associated with substance use (adjusted odds ratio [AOR]=2.0, 95% confidence interval [CI] = 1.5, 2.9), recent homelessness (AOR = 1.9, 95% CI = 1.4, 2.6), family fragmentation including divorce or separation (AOR=3.1, 95% CI 1.8, 5.2), or foster care involvement (AOR=2.2, 95% CI=1.1, 4.5) Conclusions. Welfare reform created TANF programs to address domestic violence. Women seeking GA may need similar services because of the high prevalence of violence. In the past decade, the widespread problem of domestic violence among women receiving Temporary Assistance for Needy Families (TANF, formerly Aid to Families with Dependent Children) has come to the attention of policymakers. Federal welfare reform directs states to develop special violence-prevention programs and to provide victimized women with exemptions from work requirements under a new “Family Violence Option.” These new policies recognize that ongoing exposure to violence can compromise women’s ability to meet the more demanding work requirements under welfare reform. In addition, the new policies recognize that welfare providers are in a position to take active steps to address domestic violence and related health and social problems. 1 – 3 These new policy measures are supported by epidemiological research that underscores the significance of violence in the lives of women receiving federal aid. Exposure to partner violence in the past year ranged from 20% to 30% in samples of the poor and welfare poor. 4 – 7 These estimates are 2 to 3 times higher than in the general population. 8 – 12 Previous studies further show that victimization co-occurs with numerous other health and social problems, linking domestic violence among welfare recipients to homelessness, 13 – 15 human capital and employment deficits, 16 , 17 and poor physical and mental health. 4 Numerous studies in welfare and nonwelfare populations link victimization to alcohol and drug dependence and abuse. 6 , 18 – 21 For example, a study of Michigan TANF recipients documented a 5-fold increased risk of substance dependence among women reporting domestic violence in the past year. 6 The literature also suggests that ongoing exposure to violence can limit women’s capacity to achieve economic independence—a central goal of welfare reform. 22 – 25 A noteworthy 3-year longitudinal study by Byrne and colleagues suggested that violent events trigger broad economic destabilization and unraveling in the day-to-day lives of low-income women. 26 Women who reported physical or sexual violence at one point in time were more often found to be living below the federal poverty level over subsequent observations. Violence was associated with other problems, such as divorce, unemployment, and further victimization. Such studies point to the complexity of the problems surrounding women who report being the victim of interpersonal violence, as well as to the significance of violence as a barrier to economic independence for women receiving public aid. Previous studies have made important contributions by documenting the extent of domestic violence among poor women receiving TANF and have identified related co-occurring health and social problems. However, these studies have typically focused on partner-inflicted violence to the exclusion of other forms of violence that impinge on the lives of women in poverty. Such an overly narrow definition of violence fails to capture the extent of the damage it causes. Broader work based on population and clinically-based samples suggests that sexual and physical assaults in general are associated with significant health and social harms, including physical health problems, 27 – 29 mental health consequences 18 – 20 , 30 , 31 physical functioning limitations, 27 , 30 , 32 and poorer health. 33 – 35 Moreover, in focusing on partner violence, previous research has been largely confined to studies 2 , 6 , 7 , 16 , 17 , 36 of women with children on TANF. We are unaware of any studies that focus on the health risks associated with violence in the lives of single women who receive welfare benefits who are eligible only for local aid through General Assistance (GA) and General Relief (GR). State and local GA serves as a “last resort” program for those who do not meet the federal requirements for TANF (i.e., women with dependent children) or Supplemental Security Income (SSI). 37 , 38 GA programs are locally funded, and this fragile funding base has meant the recent closing of GA programs in many states. Despite the common misconception that these local aid programs cater exclusively to unattached men, recent studies revealed that substantial numbers of women are served by GA. In 1991, the Michigan GA population was 39.8% women. 39 Studies of the GA population also suggested that these aid recipients possess more of the key risk factors associated with victimization than the Aid to Families with Dependent Children/TANF population, including alcohol and drug problems, mental and physical health problems, family distress, and homelessness. 40 – 43 These factors point to the importance of directing research efforts—and perhaps ultimately violence prevention programs—at a broader spectrum of forms of violence and a wider range of women receiving public aid. We addressed these limitations by examining victimization in a representative sample of 1235 poor women seeking welfare benefits from federal TANF and local GA throughout a large California county welfare system. We used a broader definition of interpersonal violence than previous studies—one that includes episodes of physical and sexual assault by anyone in these women’s lives, with specific information on partner assault. We compared experiences of interpersonal violence among women with dependent children applying for TANF and single women without dependent children applying for local GA. We compared the prevalences for different forms of victimization and examined related health and social problems, as well as the extent to which these problems differed in the 2 populations of women receiving public aid.
