When Research Hits Home – and the Heart

Diana Romero

Diana Romero is associate professor of urban public health at Hunter College and The Graduate Center

Diana Romero knows firsthand what it’s like to struggle. The daughter of Puerto Rican parents in New York City, she grew up in a low-income family. When it came time for college, there were no family funds, so she became a full-time student – and a full-time worker.

“I always took the maximum number of credits because it was the same tuition whether you took 12 or 18,” she says. “Eighteen was rough because many of them included lab classes. I had hoped to graduate in three years.”

It took her the full four, but she continued, eventually earning a master’s in scientific journalism from New York University and a doctorate in sociomedical sciences from Columbia University. In 2007, she left her faculty position at Columbia to become associate professor of urban public health at Hunter College and The Graduate Center.

The research she focuses on – domestic reproductive health and poverty policy, factors influencing family-formation and Latino health issues – are ones that are informed by her life experiences.

Take her own life. Looking at her academic track record without the back story, one might wonder: What drove her drive? It wasn’t ambition so much as finances.

“I never knew if I was going to have enough money to finish,” she says. “Because I was working so hard and taking so many classes, I didn’t get the grades I would have liked.”

When she began studying the 1996 U.S. welfare reform law, she was struck by the family-cap policy that is in effect in 24 states. The policy was designed to be a “financial contraceptive” – indigent women who gave birth while getting aid were denied additional assistance for the new child. The idea was not to reward poor women for having children.

She conducted a study at New Jersey health clinics and welfare offices, interviewing 32 current or former welfare recipients, only to discover that contraceptive and family-formation attitudes and behaviors were not influenced by the family-cap policy; in fact, none of the women even knew about or understood it. “This was the first time that a study looked at the policy from the perspective of the women who were subject to it,” Romero says.

Armed with this information, Romero and colleagues reviewed all the stats from the state and national studies that had been done on the family-cap policy. They discovered not only that it didn’t appear to influence poor women’s reproductive health behaviors but that it also violates eight international human and reproductive rights documents, several of which have been signed by the United States. “We were surprised that most of the major analyses showed no major impact of the policy,” she says.

The paper she co-authored, “U.S. Fertility Prevention As Poverty Prevention: An Empirical Question and Social Justice Issue,” was published last year in the journal Women’s Health Issues. It has been nominated for Reseach!America’s 2010 Garfield Award, which “recognizes outstanding research that illustrates how medical or health research impacts the economy” and includes a $10,000 award.

“Getting the papter publishes is an important first step,” she says, “to getting the policy changed.”

Romero’s finishing another paper that focuses on the key state administrators of the family-cap policy. “The law doesn’t even require the states to evaluate the policy to see whether it’s working,” she says. “Many administrators confirm it doesn’t work and feel it’s detrimental to the mothers.”

Romero hopes to use this paper’s findings to support evidence-based advocacy for discontinuation of the family-cap policy. “It will give us the ammunition we need,” she says, adding that she wants to partner with community-based groups. “And if we do win the $10,000, that will provide the seed money to take this to the federal level, including a congressional briefing.”

The last time Romero and colleagues took their case to Congress to advocate for welfare reform, in 2002, they focused on maternal and child health. To get welfare, recipients are required to work. After studying 500 welfare mothers whose children had health issues, she concluded that the biggest impediment to their holding full-time jobs was their own health. She and other advocates worked with key members of the Senate Finance Committee on bill language that would categorize taking care of an ill child as work under the welfare rules.

“It wouldn’t have exempted mothers from work, but it would have given them an option,” she says. “It would have been more effective if it had pertained to their own health, not that of their children. The bill never made it to a full vote; it was bumped for deliberations on whether to go to war in Iraq.”

Romero’s long-range research, which is financed by a five-year $600,000 grant from the National Institutes of Health, focuses on how poor and non-poor women and men make decisions about marriage, childbearing and other aspects of family life.

“There’s not a lot of rich or in-depth information on this subject that includes more affluent populations,” she says, adding that the grant also supports a doctoral student. “It’s social science work. I’m exploring how people decide whether to marry, live together and have children, and how economic and social issues factor into their decisions.”

Romero says that the opening of the CUNY School of Public Health at Hunter College will open many doors for her. “Public health is interdisciplinary work,” she says. “The structure of the school will make it easier to meet and interact with my colleagues from other CUNY institutions and disciplines.”

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