Profile Of Disability Among Families On AFDC

Prepared by Pamela Loprest and Gregory Acs of the Urban Intitute

Prepared for The Henry J. Kaiser Family Foundation

August 1996

• Executive Summary
• Introduction
• What is Disability?
• Disability Among Women Receiving AFDC
  • Severity of Disability
  • Type of Disability
  • Health Care Service Use
  • Summary
• Disability Among Children Receiving AFDC
  • Type of Disability
  • Health Care Service Use
  • Summary
• Disability Among Families Receiving AFDC
• Disability and Work
• Conclusions
• Data Appendix

Executive Summary

The current contentious debate over how to restructure our social welfare system belies a remarkable consensus over a fundamental belief held by both political parties, endorsed by President Clinton, and echoed by most of the American public: all adults who can work, should work. But not all adult welfare recipients can work, either because they themselves are disabled or they have a disabled child who requires special care. While some disabled persons receive cash assistance under the Supplemental Security Income (SSI) program, a program specifically designed to provide benefits to the disabled, many persons with disabilities do not qualify for SSI benefits. Poor families with children not qualifying for SSI will, more than likely, qualify to receive Aid to Families with Dependent Children (AFDC), the largest cash assistance program in our social safety net.

Knowing the extent to which current recipients of AFDC can work is the first step for policy makers aiming to move women off of welfare and into work. Yet little is known about the profile of disability among women and children receiving AFDC. This study uses data from three national surveys to fill this important void.

In the debate around reforming AFDC, it is not clear what will happen to recipients with disabilities. Currently, states are conducting a variety of “experiments” with welfare programs, including time-limiting benefits anywhere from 2 to 5 years, increasing work requirements, and increasing sanctions for those who do not meet these requirements. Many of these reforms, including programs in Wisconsin, Utah, and Michigan, require some work or work-like activity from all recipients. For example, Wisconsin’s program allows for different types of activities, such as supervised work at a sheltered workshop, but all recipients must perform some work. It is not clear what wiill happen to those who canno work at all.

Many other recipients with disabilities need certain accommodations to be able to work or may have limited ability to work in the jobs available to them. The presence of children with disabilities in families on welfare, particularly single-parent families, can also inhibit work because of special child care needs. While the goal may be for all recipients to work, access to necessary resources, ranging from special equipment or training to mental health or substance abuse treatment to specialized child care, varies substantially across states and localities. And providing these resources often means increased program costs.

To examine the profile of disability among families receiving AFDC, we analyze data from the 1990 Survey of Income and Program Participation (SIPP), the National Health Interview Survey (NHIS), and the National Longitudinal Survey of Youth (NLSY). The major findings of our study are as follows:

• About 18 percent of women receiving AFDC have some disability that limits work.

• At least half of the women with a disability who receive AFDC have a serious disability. Serious disability includes women who have difficulty with basic day-to-day functions such as dressing, eating, or getting around inside the house.
• Almost 30 percent of families receiving AFDC include either a disabled mother or child. Two-thirds of these families (about 20 percent of all AFDC families) include either a disabled mother or a severely disabled child.
• These findings are remarkably consistent across the three data sets used. The narrow range of results across a variety of sources suggests these results are highly reliable.

In addition, since the data used do not fully capture limitations due to mental or emotional disorders or substance abuse, these findings probably understate the true level of disability among the AFDC population.

Thus, while work may be a reasonable goal for some or even most AFDC recipients, a significant part of the targeted population (at least 20 percent) have special needs or face specific obstacles because of disability. In fact, these barriers to work may have led families to apply for welfare in the first place.

This does not necessarily mean that all women with disabilities should be exempt from work requirements, although for some families this may be the best solution. As more employers comply with the Americans with Disabilities Act, for example, accommodations for disability may make work more accessible for AFDC recipients with disabilities. But policy makers also need to consider how to structure welfare reforms to give women with disabilities access to resources that can help overcome these barriers. In light of the relatively large number of AFDC recipients with disabilities, the potential negative effects of requiring work without access to these resources could be substantial.

Introduction

The contentious debate over how to restructure our social welfare system belies a remarkable consensus over a fundamental belief held by both political parties and most of the American public: all adults who can work, should work. Most adults receiving cash assistance from the federal government receive support through the Aid to Families with Dependent Children Program (AFDC) and most of the adults on AFDC are single mothers. Thus, if the goal of welfare reform is to put adult welfare recipients to work, we must understand the extent to which single mothers receiving AFDC “can” work.

While most participants in the current debate have acknowledged that there are some people on welfare that will have more difficulty working than others, there is no general agreement on who these groups are or their size. In this report, we focus on recipients with disability as an important group that may experience difficulty in moving to work. We examine the extent to which women receiving AFDC have limited ability to work due to their own disabilities or disabilities of their children.

Knowing the profile of disability among families on welfare is particularly important for policy makers reforming welfare programs. Currently, states are conducting a variety of “experiments” with welfare programs, including time-limiting benefits anywhere from 12 months to 5 years, increasing work requirements, and increasing sanctions for those who do not meet these requirements. Women with disabilities may have limited ability to work in the jobs available to them or may need certain accomodations to be able to work. In addition, the presence of children with disabilities in families on welfare, particularly single-parent families, may also inhibit work because of special child care needs.

Although some previous studies have included a measure of disability in trying to understand AFDC families’ movements off the caseload and into work, they have not focused on this issue and only used limited measures of disability. This study provides a more complete profile of disability among women and children receiving AFDC, both the extent and the severity. Knowing the extent to which women on AFDC have disabilities will help us to understand the impact of these changes on their families. It will also help policy makers understand the potential importance of exemptions or accommodations in program requirements for these families.

To obtain the most complete picture possible, we use information from three data sets: the 1990 Survey of Income and Program Participation (SIPP), the 1990 National Health Interview Survey (NHIS), and 1992 data from the National Longitudinal Survey of Youth (NLSY). The SIPP and the NLSY are often used to study welfare issues and the NHIS is primarily used for studying health issues.

Each of these data sets has different strengths important for this study. The SIPP contains information on the ability to perform a long list of functions for adult women. The NLSY contains more extensive information on the limitations and conditions of children. The NHIS contains information on functioning, conditions, and health care utilization. All three contain information on AFDC receipt. Each data set does differ somewhat in the sample of AFDC recipients it reflects. The SIPP data include all women who received AFDC at any time over a 32 month period. The NLSY sample includes all women ages 27 to 34 who received AFDC over the course of a year. The NHIS includes all women receiving AFDC in one month.

The next section of this report discusses briefly what is meant by disability and defines some of the terms we will use. We then profile disability among women receiving AFDC and then disability among children receiving AFDC. We also examine the extent to which families have either an adult or child with a disability. We then briefly discuss the relationship between the profile of disability and work behavior and conclude with a discussion of the implications of our findings for policy.

What is Disability?

In discussing health and disability, a number of different concepts are used, including the terms impairment, condition, functional limitation, and disability. Condition is a general term that includes any specific illness, injury, or impairment. Chronic conditions or impairments refer to long-term or permanent illnesses or defects resulting in the loss or abnormality of mental or physical functioning of a body system. Examples of impairments include the absence of a limb or body part or blindness. Examples of chronic conditions include diabetes, heart conditions, or arthritis. Functional limitations exist when a person is limited in their ability to perform certain activities or tasks. Examples include walking, dressing, bathing, or lifting objects. A given functional limitation can be caused by a variety of conditions or impairments, and the same condition or impairment may or may not result in a given functional limitation, depending on severity and other factors. For example, diabetes or highblood pressure if treated may not result in any functional limitation.

The concept most important for this study is disability. Disability results from chronic conditions, impairments, or limitations resulting in the inability to perform expected social roles. This definition focuses on the outcome of the interaction between impairments, conditions, and functional limitations and the social context. For example, a limitation in the ability to lift objects of a certain weight is only a disability if that individual is expected to do that task for work or as a regular activity. Therefore, disability can vary across time and across situations. Because our expected social roles change with age, how we measure disability also varies with age. Limitations relevant for understanding disability in a three-year old differ from those relevant for adults. In addition, the same impairments and functional limitations do not always lead to disabilities. For example, an inability to perform a certain function such as walking may cease to be disabling if accommodations are made to the environment, such as wheelchair access to buildings.

Measuring the interaction of mental and physical limitations and the social context is difficult. It depends on the expectations for the group being studied. Whether a woman receiving AFDC “can” work depends on the woman, her family situation, opportunities, and the interpretations and assumptions of those assessing whether or not she is disabled: herself, policy makers, researchers, or program administrators. Conceptually, measuring chronic conditions, impairments, and functional limitations is more straightforward, although individual empirical measures will have limitations. For this reason, in this study, we mainly use measures of functional limitations and, in some cases, chronic conditions and impairments. To obtain measures of disability, we focus on functional limitations, impairments, or conditions that would most likely reduce the ability of a woman to work or care for basic needs.

Because children with disabilities may require additional care from mothers, we also report measures for children in families receiving AFDC. Mothers of children with disabilities, particularly single mothers, may be less able to work because their children have special care needs and the potential difficulty and cost of finding alternate caretakers. Measures for children differ from those used for adult women, but are chosen to be age appropriate and reflect varying levels of disability.

Finally, it is important to note that disability encompasses mental or emotional disorders, including substance abuse, that impair an individual’s ability to carry out his or her regular activities. However, there is little data available on these conditions. Although some of the measures of disability we report will reflect limitations due to mental illness, none of the data we use fully capture these types of conditions. Since conditions such as mental illness and substance abuse can restrict the ability of welfare recipients to work, our estimates likely understate the extent of disability among families receiving AFDC.

Disability Among Women Receiving AFDC

The most commonly used measure of whether health affects the ability to work is the direct question “Do (you) have a physical, mental, or other health problem that limits the kind or amount of work you can do?” Table 1 shows the results of this question from all the data sets we use.

Source: Urban Institute tabulations.

* Sample size indicates the number of families receiving AFDC included in each survey sample.

The percentage of all women on AFDC reporting a work limitation ranges from 16.6 percent to 19.2 percent, across these data. Although the samples differ somewhat (see previous section), the range of these estimates is fairly small. These rates are considerably higher than the percent of all adult women reporting work limitations. In the NHIS, 13 percent of all women ages 18 to 64 report a comparable limitation, and, in the NLSY, 9 percent of women report a work limitation. This supports the conclusion that women receiving AFDC are more likely to have a disability that limits work than women in the general population.

Some two-parent families receive AFDC under the AFDC-UP (unemployed parent) program where one of the parents is unemployed. Because this program has traditionally been small (the AFDC-UP program was only about 10 percent of the total AFDC caseload in 1990) and because the impact of disability on the family may differ in a two-parent family than in a one-parent family, we separately report work limitations for single-parent families receiving AFDC. For the most part, the difference between the percentage of single mothers with work limitations compared to all mothers with work limitations is small, the largest difference being 1.2 percent in the NLSY data. This is not surprising since there is no clear reason to think single women would be more or less likely to be disabled than married women receiving AFDC.

Severity of Disability

Source: Urban Institute tabulations of 1990 National Health Interview Survey.

Beyond this general measure of limitations, additional measures can give us information on the severity and type of these limitations. The severity of a woman’s reported limitations in her ability to work or perform her “major activity” is shown in Table 2. A fairly large group of women receiving AFDC, 10.1 percent, report they are unable to work, indicating a fairly severe disability. Another 4.1 percent report a potentially less severe disability of being limited in the kind or amount of work they can perform. In addition, another 3.7 percent of women receiving AFDC say they are not limited in work, but in some other activity. Without knowing the activity, it is difficult to assess the severity of these limitations, although they are presumably less severe than limitations that render a woman unable to work.

Because not all women have worked or are working, women receiving AFDC were also asked about current limitations in the ability to perform the activity the woman was engaged in for most of the previous year. Options for this activity include working, keeping house, going to school, or something else. Again, women responded whether they were currently unable to perform this activity or were limited in the kind or amount of this activity. Because these women are all referring to their major activity in the past year, this measure reflects the recentness of disability as well as the severity. For example, women who reported their major activity was going to school, but who are now unable to perform this activity have experienced this change recently, probably sometime in the last six months (since this activity was their major activity over the past year.) In 1990, 6.1 percent of women receiving AFDC reported they were unable to perform their major activity of the past year. An additional 6.2 percent reported they were limited in the kind or amount of this activity. Another 5.6 percent were not limited in their major activity, but were limited in some other activity. This group could include those who are unable to work and have, therefore, not done so in the past year.

Another measure of disability is the ability to perform specific functions. Because individuals may have very different ideas about work, saying one is limited in the ability to work may mean different things to different people. For example, a woman who has always held jobs where she has to stand for long periods may report a work limitation when she has foot problems, while a woman who works sitting down may not report this same problem as a work limitation. Asking about specific functional limitations allows us to create measures of severity of disability based on less subjective answers.

To obtain a clearer idea of the severity of these functional limitations, we examine the number of and degree of difficulty in performing these functions. Women can report having one of two levels of difficulty for each limitation: they have some difficulty with the function or they either cannot perform the activity or need the help of another person. Table 3 reports these different measures of the severity of functional limitations among women receiving AFDC.

Source: Urban Institute tabulations from 1990 Survey of Income and Program Participation.

Slightly more than one-fifth of these women report some difficulty with at least one of the functions. More than 8 percent needs help or is unable to perform at least one function, indicating a relatively severe disability. Almost 12 percent report some difficulty with at least one function.

Having a limitation in one function may not be terribly disabling, depending on the function. However, being limited in several functions indicates a higher level of severity. Of women receiving AFDC, 8.2 percent have more than one functional limitation. In addition, almost 4 percent report more than one activity they are unable to perform or with which they need help. This measure captures more severe disability.

Type of Disability

In addition to degree of difficulty, the extent of disability leading from functional limitations depends on the type of function being discussed. It is difficult to generalize about the ability to work from limitations in specific functions because of the differences in requirements across jobs. However, we can make some inferences about the difficulty of working and the severity of the disability from the type of function. Table 4 separates functional limitations into difficulties with basic needs, referred to as Activities of Daily Living (ADLs) and routine needs, referred to as Instrumental Activities of Daily Living (IADLs). We include sensory limitations in the category of ADLs.

Source: Urban Institute tabulations from (*) 1990 Survey of Income and Program Participation and (**) 1990 National Health Interview Survey.

Of all women receiving AFDC, 10.6 percent report some difficulty with at least one ADL. Of these, a third (3.3 percent) report difficulty with more than one ADL, indicating more substantial limitations. In addition to those reporting difficulty with one or more ADL, 9.4 percent of women receiving AFDC have difficulty with an IADL. This indicates that about half of the women reporting functional limitations are having trouble attending to these basic needs.

Another measure distinguishing the type of functions with which a person has difficulty comes from the NHIS and is also shown in Table 4. This question directly bundles functions into “basic” and “routine” by asking whether a person “needs help with personal care needs, such as eating, bathing, dressing, or getting around the house” (basic needs) or is “limited in routine needs including everyday household chores, necessary business, shopping, or getting around for other purposes” (routine needs). Only 1.2 percent of women on AFDC report needing help with personal care. This percentage is likely smaller than those with trouble with an ADL because it reflects a combination of the type of function, the level of difficulty, and even the number of functions.

The share of women who are limited in routine activities is 13.6 percent. This percentage is somewhat higher than the percentage of women with some level of difficulty with an IADL (over 9 percent). However, this question is broader, allowing inclusion of functions that may not be in the list of specific functions asked about in the SIPP.

Health Care Service Use

In addition to limitations in performing certain functions, certain measures of health status provide information about disability. Table 5 includes measures of days stayed in bed for at least half the day, health care utilization (number of days admitted to hospital not counting child birth and number of outpatient visits to a doctor), and self-reported health status. There are concerns with each of these as a measure of disability. The number of bed days reflects illnesses that may not be chronic, and thus, may only be temporarily disabling. Measures of health care utilization reflect health status as well as access to health services which varies with income and health insurance coverage. This problem is mitigated here because all AFDC recipients are eligible for Medicaid and are in a similar income class. However, to limit these problems, we concentrate on the percentage of women with relatively large numbers of bed days, hospital days, and doctor visits, believing that these are more likely to reflect serious problems.

About 7 percent of women on AFDC report they had over 30 days in the past year where they were confined to bed for health reasons. Almost 4 percent of women were in the hospital for more than five days, and 8.7 percent had 16 or more visits to a doctor. This indicates that there is a small but significant portion of the AFDC population that has significant health problems over the course of a year. Even if these problems are not chronic, for this subset of women, health issues can be an impediment to work.

The measure of self-reported health status only reflects health at the time of the interview. However, previous research finds this is a good proxy for general health when compared with more sophisticated measures. Four and one-half percent of women on AFDC report that their health is poor, and another 17.5 percent say they are in fair health. This means that over one-fifth of this group feels they are in less than good health. This is far higher than what is reported by all women ages 18 to 64: 2 percent are in poor health and 6 percent fair are in fair health.

Source: Urban Institute tabulations from the 1990 National Health Interview Survey.

Summary

Table 6 summarizes the extent to which women receiving AFDC have some disabling limitation and the extent to which they have serious disabilities. The percent of women on AFDC with some limitation ranges from 16.5 to 20.1 percent. Using several different measures, the percent of women with a serious disability ranges from 8.4 percent to 10.6 percent.

Source: Urban Institute tabulations from (*) 1990 Survey of Income and Program Participation and (¹) 1990 National Health Interview Survey and (²) 1992 National Longitudinal Survey of Youth.

Disability Among Children Receiving AFDC

In addition to their own disabilities, women who have children with disabilities may have limitations on their ability to work. Caring for children with disabilities can involve more time, call for specialized day care, and lead to additional expenses. The extent to which any of these occur depends on the nature of the disability, the family situation, and the community in terms of available services and jobs. How having a child with a disability restricts a parent’s ability to work depends on all of these same factors and the type of jobs available to the parent. We examine the disabilities of children in AFDC families because having a child with a disability may affect a recipient’s ability to work.

We measure the disability of children receiving AFDC by examining limitations in their ability to carry out certain functions. While some of the measures are broad enough to apply to all children, others are appropriate for only certain age groups. Because children of different ages are at varying stages of development, the functions they are expected to carry out vary as well. For example, attending school is an expected activity for children over five but not for toddlers. Therefore, some of the measures of disability we use reflect age-appropriate functions.

Type of Disability

Table 7 shows the extent of functional limitations among children receiving AFDC. All statistics represent the number of families receiving AFDC with at least one child having that limitation. The first measure, limitation in major activity, is similar to that used for women on AFDC. For children under age 6, major activity involves regular play, while for children 6 to 17, the major activity is attending school. In almost 2 percent of families on AFDC, a child is unable to perform his or her major activity; this represents the most severe type of limitation. In 10 percent of families, children are limited in the kind or amount of their activity, and in an additional 4 percent of families, children are limited in some other non-major activity. Overall, almost 16 percent of families have a child with some functional limitation.

Other measures of more specific functional limitations are also shown. Only 1.7 percent of families on AFDC have young children who are limited in usual activities. This is partly due to the difficulty in diagnosing some disabilities, for example learning disabilities, in young children. In addition, 2.4 percent of families on AFDC have children between the ages of 3 and 14 with a “long-lasting” condition that limits their ability to walk, run, or use stairs.

Source: Urban Institute tabulations from (*) 1990 Survey of Income and Program Participation and (**) 1990 National Health Interview Survey.

For school-age children, the type or severity of disability can be measured in relation to the ability to carry out school-related activities. Table 8 shows several measures of the type and severity of limitations in these activities.

Source: Urban Institute tabulations from (*) 1990 Survey of Income and Program Participation and (**) 1990 National Health Interview Survey.

Of families receiving AFDC, 1.7 percent have children who are unable to attend school because of an impairment or health problem. Another 7.3 percent have children that attend a special school or classes with an additional 2 percent needing this schooling. Another 3.3 percent of families report having a child that has limited school attendance because of health. Altogether this set of measures indicates that over 14 percent of families receiving AFDC have school-age children that have some limitation in school activities. Other related measures of limitations show that 5.4 percent of families have children receiving special education services and 6.3 percent report the child has a limitation in his or her ability to do regular school work.

Health Care Service Use

In addition to functional limitations, a child’s use of, or need for, certain health care services can reflect disability. Table 9 reports a variety of these measures for children in families receiving AFDC. First, 4.6 percent of families require use of special equipment, from wheelchair to special clothing, reflecting a range of disabilities. Also, 2.6 percent of families have children under 6 who have received therapy or diagnostic services designed to meet their “developmental needs.” This too is open to the parent’s interpretation and can reflect a variety of services. About 4 percent of families have a child that has spent more than 5 days in the hospital in the last year and 6.3 percent of families have a child that has had more than 15 visits to the hospital. While both of these are likely to reflect relatively severe impairments or conditions, they include both chronic conditions and short-term acute conditions.

Source: Urban Institute tabulations from (*) 1990 Survey of Income and Program Participation and (¹) 1990 National Health Interview Survey and (²) 1992 National Longitudinal Survey of Youth.

Of families receiving AFDC, 2.6 percent have at least one child participating in the Supplemental Security Income (SSI) program. This program provides benefits for low-income persons with severe disabilities. Although individuals cannot receive both SSI and AFDC, families can have different members receiving both. The SSI program has a complex process for determining disability that is generally considered as measuring fairly severe disabilities.

Source: Urban Institute tabulations from the 1992 National Longitudinal Survey of Youth.

Finally, specific conditions that are generally chronic and severe can be used as measures of disability among children. Table 10 shows that the percent of children in families receiving AFDC with any of the listed conditions ranges from less than half a percent with serious difficulty seeing to 1.6 percent with a crippling orthopedic condition. Overall, as another measure of serious disability, 3.8 percent of families receiving AFDC have a child with 1 or more of these conditions.

Summary

Using the measures presented, we can create overall measures of some limitation among children and measures reflecting more serious disability. The measures of serious disability represent a lower bound on the share of mothers receiving AFDC whose children’s disabilities likely affect their ability to work. In these measures we do not include overall limitations in school activity because it is unclear whether some of the learning disabilities that are included in these numbers would affect mothers’ work. Table 11 provides a summary of the extent of disability and serious disability among children receiving AFDC.

The percentage of families that have at least one child with some limitation ranges from 11.1 to 15.9 percent across the data sets used. While each measure captures slightly different functional abilities, the range is fairly narrow. The measures of more serious disability among children, although more varied, range from 1.8 percent to 3.8 percent of families.

Source: Urban Institute tabulations from (*) 1990 Survey of Income and Program Participation and (¹) 1990 National Health Interview Survey and (²) 1992 National Longitudinal Survey of Youth.

Disability Among Families Receiving AFDC

To understand the extent to which women receiving AFDC are likely to have some limitation on their ability to work due to disability, we need to know the combined rate of disability among mothers and children. Table 12 reports the percentage of families receiving AFDC where either the mother or the child has some limitation due to impairments or health conditions. As we have shown, there are many ways to define and describe disability for women and children. We use three different definitions from the three data sets used in this study. Almost thirty percent of families receiving AFDC have either a women or child with some level of disability. Despite the slightly different measures from these data, the range of results is relatively narrow, varying from 27.4 to 29.5 percent.

Because children with severe disabilities are more likely than children with less severe disabilities to require additional time, specialized care, or greater costs that could limit a women’s ability to work, we also consider the extent to which families receiving AFDC have a mother with any limitations or a child with a serious disability. Again, there are many ways to measure severe disability among children. Table 12 uses three different measures of severe disability among children from the three data sets. About one-fifth of families receiving AFDC have a mother with some disability or a child with a severe disability; the figures range from 18.4 percent to 21.3 percent. Although these measures for children’s serious disability differ more substantially than the measures for mother’s limitation, the range of results is still relatively narrow.

Sources: Urban Institute tabulations from (*) 1990 Survey of Income and Program Participation and (¹) 1990 National Health Interview Survey and (²) 1992 National Longitudinal Survey of Youth. (See text for functions and chronic conditions included.)

Disability and Work

The three data sets indicate that either the mother or a child in an AFDC unit suffers from some type of disability in a substantial minority of AFDC cases. But the extent to which these disabilities preclude adult welfare recipients from working is unclear. After all, many disabled individuals have successful careers, and many long-term AFDC recipients have no limitations on ordinary activities.

In previous research, we examine the extent to which disabilities limit AFDC recipients in their attempts to move from welfare to work. For that analysis, we use data from the 1990 SIPP and examine if, after taking other important differences into account, women who have functional limitations or children with functional limitations take longer to leave AFDC for work than other AFDC recipients. Since the amount of time a woman spends on AFDC may affect her chances of leaving the program, our sample consists of only cases for which we observe the start of a spell of AFDC receipt. We then review their work/welfare status at four month intervals.

We find that, on average, a woman with no disabilities and whose children have no disabilities has a 7 percent chance of leaving AFDC for work in any given wave. If she herself has a functional limitation, the chance of leaving AFDC falls to 3.8 percent. The severity and number of the limitations matter considerably. Women who report needing help or being unable to perform the activities we consider have, on average, only a 2.5 percent chance of leaving AFDC for work. And women who report having multiple limitations have only a 2.4 percent chance of moving from welfare to a job in a given four month period. Women who report having less severe or only a single limitation are not significantly less likely to leave welfare for work than non-disabled women. Similarly, we find that having a disabled child does not inhibit AFDC exits for work. However, this finding might differ if measures that better reflected severe disability among children were available in the SIPP.

Thus, our results indicate that while disabilities are not uncommon among women and children on AFDC, women with multiple and/or severe physical limitations are more likely to be significantly inhibited in their attempts to move from welfare to work.

Conclusions

Welfare programs are currently undergoing changes in many states, as programs begin to time-limit benefits and move more recipients into work. Although programs such as Supplemental Security Income (SSI) provide cash assistance to those with severe disabilities, many poor persons with disabilities that limit their ability to work do not qualify. This profile of disability among recipients of AFDC, the largest federal cash assistance program, shows that the rate of disability among this group is large.

We find that in 17 to 19 percent of families receiving AFDC, the mother has a health condition or impairment that limits her ability to work or perform other routine functions. Between two and four percent of families receiving AFDC have a child with a seriousdisability that is likely to effect a mother’s ability to work. Altogether we find that in slightly more than one-fifth of families receiving AFDC, between 18 and 21 percent, the mother has a disability or a child has a serious disability. These findings are consistent across the three different data sources used, the SIPP, the NHIS, the NLSY. In addition, since the data used do not fully capture limitations due to mental or emotional disorders or substance abuse, we probably understate the true level of disability among the AFDC population.

The large extent of disabilities among families with AFDC has serious implications for welfare reform. Reforms that place time limits on receipt of benefits and introduce stricter requirements for work need to take into consideration the recipients’ ability to work. Under some of the current reforms being implemented by states, the goal is for all recipients to eventually be required to work. The ability of a woman to work depends, in part, on whether she or her child has a disability, the nature and severity of that disability, and the requirements of the jobs available to her. For women with severe disabilities, policy makers may want to consider exemptions from work requirements altogether. For women with less severe disabilities, accommodations in work places, alternate types of work arrangements, and specialized child care services, may make work more feasible. Increasing implementation of the Americans with Disabilities Act prohibiting discrimination against individuals with disabilities may lead to increasing numbers of employers making such workplace accommodations.

Thus, given the extent of disability in families receiving AFDC, our results suggest that putting the entire AFDC caseload to work is an unrealistic goal without further consideration of possible accommodations for these families. Policy makers reforming AFDC need to consider the impact of reforms on the large number of women and children with disabilities receiving these benefits.

Data Appendix

Survey of Income and Program Participation

The 1990 Survey of Income and Program Participation (SIPP) provides detailed information on individuals’ labor market activity, welfare program participation, and health. The SIPP is a longitudinal survey, and the 1990 panel contains information on over 20,000 households who were re-interviewed at 4 month intervals (known as waves) over a 32 month period. During the third wave, the SIPP administered a special topical module asking detailed questions about individuals’ functional limitations.

Our sample consists of women who responded to the questions in the disability topical module in wave 3 and received AFDC or General Assistance at some time over the 32 month period. To guard against spurious responses, a woman had to report receiving welfare in at least two months, and the two months must not be separated by more than a single month. Thus, we view a woman who reports receiving welfare in months 5 and 30, for example, as reporting bad data and do not include her in the sample. Women who report receiving welfare in consecutive months or in two out of three consecutive months are included.

Our sample consists of 1,409 women who received AFDC at any time over the 32 month period; 798 of these women began receiving AFDC after the first month of the survey.

National Longitudinal Survey of Youth

The National Longitudinal Survey of Youth (NLSY) began in 1979 with a cohort of over 12,000 young men and women between the ages of 14 and 21. It reinterviewed them annually, obtaining detailed information about their labor market activity, welfare program participation, and living arrangements. In 1986, the NLSY began collecting supplemental information on the children born to female respondents. During the 1986, 1988, 1990, and 1992 surveys, a battery of child physical and psychological tests were administered to NLSY mothers and their children. These mother-child data include detailed information on conditions that limit children’s activities.

Our sample consists of NLSY mothers who report receiving AFDC for at least two months during 1991 and who responded to the general mother’s disability questions and the child disability questions in the 1992 survey. We have 506 families in our sample; the mothers range in age from 27 to 34.

National Health Interview Survey

The National Health Interview Survey (NHIS) each year collects information on health characteristics, conditions, injuries, activity limitations and use of medical services from a nationally reprentative sample of the noninstitutionalized population. In 1990, data was collected from 46,476 households. Information about receipt of AFDC is not regularly collected, but a supplement on sources of income was included in the 1990 survey.

Our sample consists of women over age 16 who have children and report receiving AFDC in the past month. The sample includes 1082 families.

This research was sponsored by a grant from the Henry J. Kaiser Family Foundation. The authors would like to acknowledge David Dickenson, Eric Meier, Cori Uccello, and Keith Watson for their helpful comments and research assistance. Any opinions expressed herein are those of the authors’ and do not necessarily reflect the views of the Urban Institute or its funders. The authors claim full responsibility for all errors.

The August 1996 edition of the Kaiser Family Foundation/Harvard Health News Index includes questions about major health issues covered in the news, including questions about Medicare, the Tobacco Industry, AIDS and Abortion. The survey is based on a national random sample of 1,0003 Americans conducted August 5-7, 1996 which measures public knowledge of health stories covered by newsmedia during the previous month. The Health News Index is designed to help the news media and people in the health field gain a better understanding of which health stories in the news Americans are following and what they understand about those health issues. Every two months Kaiser/Harvard issues a new index report.

A telephone survey of 1,011 adults (between June 20 and July 9, 1996) about how health care reform (specifically Medicare reform, MSAs and the Kassebaum/Kennedy bill) fits into the upcoming November election. The survey was designed by the Kaiser Family Foundation, Harvard University, and Princeton Survey Research Associates (PSRA). The survey was conducted by PSRA. The The margin of error was plus or minus 3 percent. The survey data was released at a press briefing held in Washington, DC on July 30th, 1996. A press release, questionnaire and national topline data and briefing charts are included in this package.

THE AIDS LITIGATION PROJECT IIIA Look at HIV/AIDS in the Courts of the 1990s

Principal Investigator: Lawrence O. Gostin, J.D., LL.D. (Hon.) Professor of Law, and Co-Director, Georgetown/Johns Hopkins University Program on Law and Public Health

Co-Principal Investigator: Zita Lazzarini, J.D., M.P.H. Harvard School of Public of Public Health

Research Associate: Kathleen Flaherty, J.D. Georgetown/Johns Hopkins University Program on Law and Public Health

Research Assistant: Robert Scherer, (J.D. candidate, 1997) Georgetown/Johns Hopkins University Program on Law and Public Health

Program Officer: Mark Smith, M.D., M.B.A. Executive Vice President, Kaiser Family Foundation

Supported by a grant from the Kaiser Family Foundation

Contact:

Lawrence O. Gostin, J.D., LL.D (hon.) Professor of Law Georgetown University Law Center 600 New Jersey Ave., N.W. Washington, D.C. 20001-2075 tel: (202) 662-9373 fax: (202) 662-9409 e-mail: gostin@law.georgetown.edu

ACKNOWLEDGMENTS

This project would not have been possible without the help of many colleagues. The Kaiser Family Foundation was instrumental in the development of the AIDS Litigation Project, in both funding and intellectual support. Mark Smith nurtured and helped develop the project; Jeff Stryker helped in the project’s conceptualization and dissemination; and Bev Wright assisted us in numerous aspects.

The authors would especially like to thank the following students for their research assistance: Charles Whipple, Nancy Park, Deirdre Kamber, and K. Michele Bradshaw.

The AIDS Litigation Project III: A Look at HIV/AIDS in the Courts of the 1990’s

This study compiles and analyzes 310 cases decided in state and federal U.S. courts since January 1991 in which AIDS or HIV was an important aspect of the facts presented. The review includes cases reported in state and federal courts as of June 1996, classified, summarized, and evaluated according to subject matter. The report was released at a joint briefing held by the Kaiser Family Foundationand the National Press Foundation in Washington, D.C. on July 24, 1996.

• Report

THE AIDS LITIGATION PROJECT III: A Look at HIV/AIDS in the Courts of the 1990s

Supported by a grant from the Kaiser Family Foundation

FOREWORD

ACKNOWLEDGMENTS

METHODOLOGY

EXECUTIVE SUMMARY

• AIDS Education
• Protection of the Blood Supply
• Public Health Powers and Epidemiological Surveillance
• State Restrictions on Persons: Criminal Law
• Private Tort Actions
• Duty to Protect Workers
• Administration of Justice
• Family Law
• Privacy and Confidentiality
• Discrimination
• The Rights of Vulnerable Persons: Prisoners
• The Rights of Vulnerable Persons: The Homeless
• Conclusion

REPORT

This report provides an overview of the Arizona Medicaid experience and contains valuable insights into the evolution and experience of a mandatory statewide Medicaid managed care program covering both acute care and long-term care services.

Note: This publication is no longer in circulation. However, a copy may still exist in the Foundation’s internal library that could be reproduced. Please email order@kff.org if you would like to pursue this option.

12. Well now I’m going to read a list of reasons why some people say teenagers have sex. For each one, please tell me if you think this is often a reason, sometimes a reason, or hardly ever a reason teenagers have sex. (First), (Insert item. Rotate items.) — how often is this a reason?

Often a reason Sometimes a reason Hardly ever a reason DK Ref. a. Because they think they are ready to have sex 55 38 6 1 * Boys 51 42 6 1 0 Girls 59 35 6 * * Has Had Sex 71 26 3 0 0 Not Yet Had Sex 48 43 8 1 0 b. Because they want to be popular 42 41 16 1 * Boys 42 43 15 1 0 Girls 41 40 18 1 * Has Had Sex 43 41 15 * 0 Not Yet Had Sex 41 41 17 1 0 c. Because the (boy/girl) they’re with is pressuring them 41 39 19 1 * Boys 23 44 33 1 0 Girls 61 34 5 * * Has Had Sex 38 40 22 * 0 Not Yet Had Sex 43 38 18 * 0 d. Because they don’t want people to tease them for being a virgin 41 40 19 * * Boys 43 41 15 1 0 Girls 38 39 22 1 * Has Had Sex 42 37 20 0 0 Not Yet Had Sex 40 41 18 1 0 e. Because they’re just curious about it 41 44 14 1 * Boys 40 42 17 1 0 Girls 42 47 11 * * Has Had Sex 50 40 11 0 0 Not Yet Had Sex 38 46 16 1 0 f. Because they want to be loved 36 48 16 * * Boys 28 52 19 1 0 Girls 45 42 13 * * Has Had Sex 49 43 14 0 0 Not Yet Had Sex 33 49 17 1 0 g. Because movies and TV shows make it seem like it is normal for teenagers to have sex 34 42 23 1 * Boys 36 43 20 1 0 Girls 32 40 27 1 * Has Had Sex 32 40 28 * 0 Not Yet Had Sex 35 42 21 2 0 h. Because someone forces them to have sex against their will 22 53 24 1 * Boys 19 48 32 2 0 Girls 26 59 14 1 * Has Had Sex 23 55 22 * 0 Not Yet Had Sex 22 52 25 1 0 13. Have you yourself ever had sexual intercourse?

Total Boys Girls Has Had Sex Not Yet Had Sex Yes, had intercourse 29 33 25 100 0 No 70 66 73 0 100 Not sure/Don’t know * 1 * 0 0 Refused 1 1 2 0 0 14. Do you think either of your parents knows you have had sex? You don’t have to say which parent, just say yes if you think either one does.

Based on those who have had sexual intercourse. (n=497)

Total Boys Girls Yes 65 61 69 No 32 35 29 Don’t know 3 4 2 Refused * * 0 15. Whenever you have had sex, have you or the (boy/girl) you were with used birth control all the time, most of the time, only sometimes, or not at all?

Based on those who have had sexual intercourse. (n=497)

Total Boys Girls All the time 48 53 42 Most of the time 24 18 31 Only sometimes 15 14 17 Not at all 11 12 9 Not sure/Don’t know 1 2 0 Refused 1 1 0 16. Which of the following are reasons you sometimes don’t use birth control — just say “yes” or “no” for each one. (First), (Insert item. Rotate items) — is this a reason for you?

Based on those who have had sexual intercourse and did not use birth control all the time.

Yes No DK Ref. a. You can’t always plan ahead for when you’re going to have sex 66 34 * 0 (n=252) Boys 62 39 0 0 Girls 70 29 1 1 b. (You/the girl you’re with) (don’t/doesn’t) like the side effects of certain kinds of birth control 33 65 2 0 (n=253) Boys 29 67 3 0 Girls 37 63 1 0 c. The (boy/girl) you’re with doesn’t want to use birth control 30 70 * 0 (n=253) Boys 27 73 * 0 Girls 32 68 0 0 d. Birth control interrupts the moment 30 69 1 0 (n=253) Boys 27 72 1 0 Girls 33 66 1 0 e. Sex doesn’t feel as good with birth control 29 70 1 0 (n=253) Boys 31 69 1 0 Girls 27 72 1 0 f. You feel sure (the girl you’re with/you) won’t get pregnant if you risk it once in a while 28 71 1 0 (n=253) Boys 31 67 2 0 Girls 25 75 0 0 g. You can’t afford birth control 12 87 * 1 (n=253) Boys 10 90 * 0 Girls 14 84 0 2 h. It’s too embarrassing to talk about birth control with the (boy/girl) you’re with 10 90 0 0 (n=253) Boys 12 88 0 0 Girls 8 92 0 0 i. (You/the girl you’re with) (want/wants) to have a baby 7 92 1 0 (n=253) Boys 9 90 2 0 Girls 6 95 0 0 j. You or the (boy/girl) you’re with (don’t/doesn’t) know how to use birth control 7 93 * 0 (n=253) Boys 11 89 * 0 Girls 3 97 * 0 17. I’m going to read the list of birth control methods one more time. I want you to tell me which of these you or the (boy/girl) you were with have used most often by saying “yes” when I get to that method. If you use two methods at a time, you can say yes twice. Have you most often used (Insert item)?

Respondents read abstinence and each method that they said they knew “a lot” or “a little” about in Q.23. Based on those who have had sexual intercourse and have used birth control.

Total Boys Girls Condoms 87 88 86 Birth control pills 41 44 38 Withdrawal 15 16 14 Depo Provera (the shot) 6 4 8 The rhythm method (safe time of the month) 5 6 3 Norplant (implants) * * 1 Some other method 2 2 1 Don’t know * * 0 Refused 0 0 0 (n=418) Total exceeds 100% due to multiple responses.

18. If girl: Have you ever taken a pregnancy test? (If yes: How many times have you done this?)

If boy: As far as you know, has any girl ever taken a pregnancy test because she thought you got her pregnant? (If yes: How many times has this happened?)

Based on those who have had sexual intercourse.

Total Boys Girls Once 16 12 21 Two times 6 4 9 Three times 3 1 6 Four times 2 3 1 Five or more times 1 * 2 No/Never 68 77 55 Don’t know 1 1 2 Refused 3 2 4 (n=497)

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Survey on Teens and Sex: What They Say Teens Today Need to Know, And Who They Listen To:Press Release Survey Part One Part Two Part Three Part Four Part Five Chart Pack

Media Coverage Of AIDS: Broad-Based, Consistent Over Past Decade

Focus Shifts, However, From Science/Medicine to Celebrity-Oriented

Embargoed for release until: 9:00 a.m. E.T., Wednesday, June 26, 1996

Contact: Matt James or Tina Hoff

Washington, D.C. — Media coverage in the U.S. of AIDS over the past decade has generally remained broad-based and consistent, emphasizing prevention and protection and avoiding becoming overly politicized, although focusing almost entirely on the epidemic as a domestic concern. However, while coverage in the early years of the epidemic focused heavily on the scientific and medical aspects of AIDS as an important new threat to public health, news items concerning AIDS in recent years have become more celebrity-oriented. These are among the key findings of the Kaiser Family Foundation’s new analysis of newspaper and network television coverage of AIDS from 1985 through early 1996. The study was conducted for the Foundation by Princeton Survey Research Associates (PSRA), and will be disseminated by the Columbia Journalism Review.

“By and large, the media did a good job covering AIDS over the past ten years,” said Mark Smith, executive vice president of the Kaiser Family Foundation. “This may be why Americans have generally high levels of knowledge about how HIV is transmitted and can be prevented.”

The Kaiser/PSRA study analyzed media coverage of AIDS over the last ten years by examining 26 randomly-selected “typical” news weeks and eight peak weeks of AIDS news coverage triggered by a “major event” involving AIDS. Three national newspapers were monitored (The New York Times, The Washington Post, and USA Today), as well as the evening news programs of the three major broadcast networks: (ABC World News Tonight, CBS Evening News and NBC Nightly News). In addition to these national media outlets, two regional newspapers were selected: The St. Louis Post-Dispatch to represent local media in this country’s heartland; and The San Francisco Chronicle to represent local media serving a geographic areas disproportionately affected by AIDS.

Media Maintained Consistent, Broad-Based Coverage

During typical news weeks, the media examined in this study ran approximately 30 stories per week focused on AIDS. In a major event week, that number increased to at least 50 stories, registering an “off-the-charts” reading of 259 stories during the biggest AIDS news week in history — when Magic Johnson’s announced to the world that he was HIV-positive (November 1991). At least temporarily, major AIDS news events increase the overall volume and prominence of AIDS news stories.

Over the ten years, AIDS has not developed into a political story. In fact, only 3% of all stories in typical news weeks dealt with the impact of AIDS on the political process. Nor has AIDS coverage tended to focus on specific populations; rather most stories dealing with the impact of AIDS highlight its effects on all HIV-positive individuals (33%) or two or more of the higher-risk groups (29%).

Prevention/Protection a Major Focus of AIDS Reporting

AIDS prevention was the main focus of most AIDS news stories run during typical news weeks (20%), followed by treatment (13%), transmission (13%) and research (13%). Media coverage of these public education topics during typical news weeks peaked in the mid-to-late 1980s. Coverage of celebrities who have AIDS or are HIV positive, particularly Magic Johnson, have in recent years generated significant additional coverage in this area and at times when people may be more attentive.

“Though AIDS coverage has been thorough, trends in coverage indicate that this may be changing,” said Andrew Kohut, PSRA’s chairman. “Stories are getting shorter, focusing more on celebrities, and increasingly being found in the soft news sections of papers. Over time, this could have an impact on the public’s knowledge of issues in AIDS.”

AIDS Treated As a Domestic Story

The media treated AIDS as almost exclusively a domestic story. Overall, only 4% of AIDS stories were filed from non-U.S. datelines, and the sole recurring lead with any international component involved AIDS as an immigration issue (1%).

Major Changes in AIDS News Coverage Over Time

• Celebrities have replaced the scientific/medical community as top news makers in AIDS stories. In 1989, members of the scientific and medical community were the principal news maker in about three of 10 (29%) AIDS focused-stories during typical weeks, while celebrities or public figures played this role in only 5% of stories. In five of the six subsequent years, however, celebrities emerged as the leading principal news maker. In 1995, the last full year of the study, celebrities outscored the scientific and medical community by 25% to 14% as the top news maker.
• AIDS coverage has shifted toward the “softer” news sections, such as sports and lifestyle. Prior to 1991, AIDS coverage was virtually nonexistent in sports sections of newspapers and newscasts. But in three of the five years from 1992-95, sports accounted for 15% or more of all AIDS-focused stories. Since the late 1980s, the lifestyle section’s share of AIDS coverage has also about doubled. Coverage in both was no doubt driven by the increased focus on celebrities as news makers around AIDS issues.
• AIDS has been incorporated into the regular news agenda. In 1987, two-thirds (69%) of all news stories with any mention of AIDS had AIDS as their primary focus, while one-third (31%) made only a passing reference to the disease . By 1994, these figures reversed themselves (30% primary focus vs. 70% not primary focus) as AIDS was more often treated as one of several national problems along with crime, substance abuse, homelessness, etc.
• The length of the average AIDS news story has decreased. In three of the first four years studied (1985-88), over a quarter of all AIDS-focused newspaper stories run during a typical week were 700 words or more. In subsequent years, longer articles accounted for such a large a share of AIDS newspaper stories only once (1993=26%).

Trends in Media Coverage of AIDS and the Public’s Knowledge and Attitudes Toward the Disease and Epidemic. Though surveys often find that Americans are ill-informed about most national issues, they are generally knowledgeable about AIDS prevention and treatment, which have been major focuses of media coverage over the past 10 years. According to the Kaiser Family Foundation’s survey of Americans on AIDS, most Americans know that AIDS can be transmitted through sexual intercourse (97%), that a pregnant woman with AIDS can pass the virus to her baby (94%), that no vaccine is currently available to protect a person from getting AIDS (88%), and that drugs are available that can lengthen the life of a person infected with AIDS (75%).

One notable gap in the public’s knowledge, however, is a misperception among most Americans (51%) that the proportion of AIDS cases that occur inside the U.S. relative to the rest of the world is greater than it really is. This may be due in part to the lack of international AIDS stories in the U.S. media, which largely focuses on the epidemic from a domestic perspective.

Americans say they rely heavily upon the news media for information on AIDS, with television (67%), newspapers (54%) and magazines (50%) being cited as the top three major sources for the public of AIDS information.

Methodology

For this study of AIDS news coverage, Princeton Survey Research Associates examined over 3,100 news stories including the terms “AIDS” or “HIV” that appeared in selected newspapers and television newscasts during 34 designated weeks between 1985 and 1996.

The Kaiser Survey on Americans and AIDS/HIV was a national random-sample telephone survey of 1,511 adults, 18 years and older, including over samples of 250 African Americans and 250 Hispanics. The survey was designed by the Kaiser family foundation and PSRA and was conducted by PSRA between November 27-December 17, 1995.

Kaiser Family Foundation Survey on Teens and Sex: What They Say Teens Today Need to Know, And Who They Listen To

Final Topline: Teenager Interview

June 24, 1996

Conducted for The Henry J. Kaiser Family Foundationby Princeton Survey Research Associates

Number of Interviews: 1,510 teenagers age 12-18 Margin of Error: plus or minus 3 percentage points Dates of Interviewing: March 28 – May 5, 1996

Introduction:

Hello, my name is __________ and I’m calling for Princeton Survey Research, in Princeton, New Jersey. We’re taking a confidential national opinion survey about some important health issues. First, in order to be sure we are representing the opinions of people in different kinds of households . . .

A. I’d like to know if there are any teenagers now living in your household, that would include anyone as young as age twelve up to, and including, age eighteen?

B. How many teenagers from age 12 up to age 18 live in your household?

C. Is (this teenager/the (Rotate: oldest/youngest) of these teenagers) a boy or a girl?

D. How old is (he/she)?

E. Are there any teenagers up to age 18 who usually live here but who are now away at college?

F. Does the teenager who’s away at college live in a dormitory, his or her own apartment, or somewhere else? (If more than one teen away ask about oldest)

G. Is this teenager a boy or a girl?

H. How old is (he/she)?

I. If only a teen in household or only teen away at college: Are you (his/her) (mother/father)?

If both a teen in the household and a teen away at college ask: Are you the (mother/father) of the (Age) year old (boy/girl)?

J. I’d like to speak with one of the parents of the (Age) year old (boy/girl) (who is living at school), whichever parent is available for a short interview now. (If child lives with a guardian instead of a parent, interview a guardian)

Teenagers’ Interview:

(If teenager did not answer screening questions): Hello, my name is_________ and I’m calling for Princeton Survey Research in Princeton, New Jersey. We interviewed your (mother/father/guardian) and (she/he) said it was okay if we interviewed you, too. We are talking to teenagers about some health issues.

(If teen is away at college in a dormitory and a parent interview completed: When we spoke to your (mother/father/guardian) earlier, (she/he) said we could call you at this number.)

This is a completely confidential interview. No one who knows you, including your parents, will ever be told how you answered these questions.

1. Which of the following subjects, if any, have you ever discussed with either of your parents? (First/Next), how about (Insert item) — have you discussed this, or not?

Yes No DK/Ref. a. Alcohol 78 22 * Boys 75 25 0 Girls 81 19 0 Has Had Sex 82 18 * Not Yet Had Sex 76 24 0 b. Dating 78 22 * Boys 71 30 0 Girls 85 15 * Has Had Sex 81 19 * Not Yet Had Sex 76 24 * c. Drugs 77 23 * Boys 76 24 * Girls 78 22 * Has Had Sex 81 19 * Not Yet Had Sex 74 25 * d. Sex 74 26 * Boys 70 31 0 Girls 79 21 * Has Had Sex 77 23 * Not Yet Had Sex 73 27 * e. AIDS 69 31 0 Boys 68 32 0 Girls 71 29 0 Has Had Sex 71 29 0 Not Yet Had Sex 68 32 0 f. Other sexually transmitted diseases 55 45 * Boys 52 48 * Girls 59 41 * Has Had Sex 61 40 0 Not Yet Had Sex 52 48 * g. Birth control 46 54 * Boys 38 61 * Girls 54 46 * Has Had Sex 62 38 0 Not Yet Had Sex 39 60 * An asterisk indicates a value of less than 1%.

For the rest of this interview, I’m going to be asking questions about sex and pregnancy, topics some people have trouble talking about. So, if I ask a question you don’t want to answer, just tell me. If I ask about something you don’t know, that’s okay too, just tell me you don’t know.

2. Teenagers get information about pregnancy and birth control from many different sources. For each of the following, please tell me if you have learned a lot, some, only a little, or nothing at all about pregnancy and birth control from this source. (First/How about), how much have you learned from (Insert item)?

A lot Some Onlya little Nothingat all Doesn’t apply DK/Ref. a. Teachers, school nurses or classes at school 40 29 20 11 0 * Boys 41 27 20 13 0 0 Girls 40 31 19 10 0 * Has Had Sex 36 28 25 12 0 0 Not Yet Had Sex 42 30 18 11 0 * b. Your parents 36 36 23 5 0 * Boys 31 37 26 6 0 1 Girls 41 35 20 4 0 * Has Had Sex 41 29 25 5 0 0 Not Yet Had Sex 34 39 23 5 0 1 c. Other friends 27 33 22 18 * * Boys 24 29 25 22 * * Girls 29 38 19 14 * 0 Has Had Sex 40 34 15 11 * 0 Not Yet Had Sex 21 34 25 21 * * d. Television shows or movies 23 31 32 14 0 * Boys 22 31 33 14 0 0 Girls 23 31 32 15 0 * Has Had Sex 28 29 30 13 0 0 Not Yet Had Sex 20 32 34 14 0 * e. Books or pamphlets 16 27 34 22 1 * Boys 11 24 38 28 * * Girls 22 31 31 17 * * Has Had Sex 21 28 29 20 1 * Not Yet Had Sex 14 27 37 23 * * f. (Boy/girl)friends 13 17 19 50 1 * Boys 17 19 20 44 1 * Girls 9 15 19 55 2 0 Has Had Sex 31 27 18 24 * 0 Not Yet Had Sex 5 13 20 61 2 0 g. Your brothers, sisters or cousins 12 19 21 46 2 0 Boys 12 17 23 47 1 0 Girls 13 20 20 45 2 0 Has Had Sex 20 19 19 40 2 0 Not Yet Had Sex 10 19 22 48 2 0 h. Magazines 12 27 32 29 * * Boys 5 19 36 39 * 0 Girls 19 36 28 17 * * Has Had Sex 12 29 33 26 * 0 Not Yet Had Sex 12 27 32 30 * * i. A family planning clinic like Planned Parenthood 9 9 11 70 * 1 Boys 5 9 12 72 1 1 Girls 13 9 10 67 * 1 Has Had Sex 17 11 11 60 * * Not Yet Had Sex 6 8 11 74 1 1 j. A doctor or nurse at a doctor’s office or hospital 9 15 21 55 * * Boys 7 13 20 60 * 0 Girls 12 17 21 50 * * Has Had Sex 15 15 20 50 * 0 Not Yet Had Sex 7 14 21 58 * *

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Survey on Teens and Sex: What They Say Teens Today Need to Know, And Who They Listen To:Press Release Survey Part One Part Two Part Three Part Four Part Five Chart Pack