Office of Epidemiology and Research, Division of Research

Advancing Applied MCH Research

(SDAS) Welfare, Maternal Employment, and On-Time Child Immunization Rates

Funded Projects Search

Advanced Search >>

Project Number: R40 MC 17178-01
Grantee: Northwestern University
Department/Center: Feinberg School of Medicine/Inst. for Healthcare Studies
Project Date: 02/01/2010

Final Report

(SDAS) Welfare, Maternal Employment, and On-Time Child Immunization Rates Final Report (PDF) Exit Disclaimer

Principal Investigator

Min-Woong Sohn, PhD
Research Assistant Professor
750 N Lake Shore Dr FL 10TH
Evanston, IL  60611-4550
Phone: (312) 503-5582


  • Perinatal/Infancy (0-12 months)
  • Toddlerhood (13-35 months)
  • Early Childhood (3-5 years)


Healthy People 2010 target (14-24a) for the proportion of young children who receive all vaccines recommended for universal administration (4 diphtheria, tetanus, pertussis; 3 polio; 1 measles, mumps, rubella; 3 haemophilus influenza type b; 3 hepatitis B - 4:3:1:3:3) is 80%. Substantial achievements toward that goal have been made, but there still remain differences in immunization rates among race/ethnicity and income groups. In fact, these differences may be growing as the nation pushes for the last few percentages to achieve the target. Some subgroups of the population may be substantially undervaccinated and be vulnerable to vaccine-preventable morbidity, mortality and other health hazards. One of such subgroups includes children whose mothers were on welfare after the reform of 1996 and were required to work. Despite concerns about how welfare reform would affect health of the low-income children in general and immunization rates in particular, no systematic data have so far been collected to examine how welfare reform and its work-related provisions affected child immunization rates. The overall aim of this project is to take advantage of a longitudinal study of children's health and healthcare to examine how maternal work and welfare status are associated with immunization status for low-income children in Illinois whose families were in transition from welfare to work. The Illinois Family Study: Child Well Being (IFS-CWB) study collected detailed data on children's health and healthcare utilization for preventive, sick, and follow-up visits through four annual waves (1999-2004) of surveys for children who were 0 to 3 years old in 1999. The survey data were linked to medical charts, state administrative data, and Medicaid claims data. The linked data include detailed information on immunizations, welfare receipt status, maternal employment, Medicaid enrollment, and other baseline and annual demographic information (e.g., family income, and living arrangements). Two specific aims are (1) to describe the role of work and welfare status on child immunization rates by comparing immunization rates of children in families in transition from welfare to work with immunization rates of all US children from the National Immunization Survey and (2) to examine factors associated with on-time uptake of each vaccine by children in families in transition from welfare to work. Specifically, we will examine how maternal employment, welfare receipt, and Medicaid enrollment affected ontime child immunization rates, controlling for other predisposing, enabling, and illness factors.


Listed is descending order by year published.

Please visit the Grantee's Publication web site for a complete list of Publications. Exit Disclaimer

Holl JL, Oh EH, Yoo J, Amsden LB, Sohn MW. Effects of welfare and maternal work on recommended preventive care utilization among low-income children. Am J Public Health. 2012 Dec;102(12):2274-9.

Sohn MW, Yoo J, Oh EH, Amsden LB, Holl JL. Welfare, maternal work, and on-time childhood vaccination rates. Pediatrics. 2011 Dec;128(6):1109-16.


Immunization, Access to Health Care, Insurance Coverage, Primary Care, Well-Child Pediatric Care, Health Disparities

Title V in Your State