February 24, 2014

The Holes You Can’t See

by Natalie Posever '14.5

Natalie Posever ‘14.5 is an anthropology concentrator. She has volunteered as an advocate for Health Leads at Hasbro Children’s Hospital since the fall of her freshman year, and is continually reminded of the power of a child’s environment to dictate his health and well-being with each day she spends at the clinic.

I recently read a book that detailed the process low-income women have to go through to obtain free public prenatal care in New York state. The application process takes an entire day, a day during which the mother-to-be must take time off of work, leave the older kids with a friend, and travel to the prenatal clinic. At the clinic, she will take a pregnancy test (no, it doesn’t matter if you’ve taken one already,) meet with a nutritionist, social worker, nurse, and financial counselor. After all of this, she will need to wait until her test results come in (no, not until tomorrow) and then return to the clinic to schedule her first appointment (sorry, there are no appointments for another two weeks.) Although this is a relatively laborious example, it is not too far from what is played out across the country each day as low-income mothers, fathers and children seek to become recipients of social services provided by the government.

Securing free prenatal care is just one piece of the puzzle. If she qualifies, mom will need to go to the WIC office (no, it’s not very close by) to begin receiving nutritional supplements and food during her pregnancy, she may need to go to another office to apply for SNAP (formerly known as Food Stamps), and once the baby is born she may start a similarly arduous journey as she tries to navigate the resource landscape designed to support the nation’s poorest kids, all at the same time that she is hoping to rest and relax with the new addition. It comes as no surprise that many families face challenges in applying for all of these public benefits.

From the barrage of acronyms housed under the umbrella term “welfare,” it appears as if there is a well-established, comprehensive network of services available to provide families the opportunities they deserve. Perhaps if this system functioned perfectly, in an ideal world where everyone who needed something was eligible for it, and everyone who was eligible received it, this would be true. However, there exist so many holes, and so many families who fall through the cracks. How can this fragmented “welfare package” be designed to comprehensively support families, as it proclaims to do? This is the question in the back of my mind as I sit with the other members of the Pre-to-Three team, perched in an office overlooking the river.

We have come together to discuss the survey instrument we are designing for our project on continuity of care for children aged “pre-to-three.” Only 15 minutes in to our discussion, it has become apparent to me that the siloed nature of the public welfare system, as described above, runs deeper than straight service provision. 

“So, would it be possible to match our survey data with data about Home Visiting, or SNAP, or WIC?” I naively ask.

One of the phenomenal community partners on our team replies, “Well, the trouble is that there are a lot of politics involved. You need to get permission from the various agencies, and consent from the families.”

These are the institutionalized walls that separate different services and simultaneously act to separate families from getting the services they need, suddenly made visible to me. It is my hope that our project serves to expose and identify more walls as we look towards a continuous, family-centered social service net.

 

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