But a major research question remains relatively unexamined, according to Northwestern University's Celeste Watkins-Hayes.
The question at the heart of Watkins-Hayes' research: How do HIV-positive individuals, especially those who are low-income, gather and use the financial resources necessary to help manage their health?
Watkins-Hayes, assistant professor of African American studies and sociology in the Weinberg College of Arts and Sciences, is receiving considerable funding for a first-of-its-kind study of the economic survival strategies of a racially and socioeconomically diverse array of women living with HIV in the Chicago area.
She is a recent recipient of the Faculty Early Career Development (CAREER) award from the National Science Foundation (she will receive $411,000 over five years) and a grant from the Robert Wood Johnson Foundation.
The goal of her research is to reveal the relationship between economic strategies and health management in order to determine what arrays of social support and financial assistance from public, private and non-profit sources provide the stability necessary to allow women to focus on improving their health following an HIV diagnosis.
As HIV in the U.S. has shifted to a disease increasingly affecting those with low income, Watkins-Hayes stresses that economic survival strategies are the missing link. "For impoverished populations, living in this economy is clearly a challenge," Watkins-Hayes said. "But living with the added hardships of HIV is daunting."
Watkins-Hayes is interested in how these women, often the caretakers of their families, get money and spend money and how that affects their ability to manage their health -- take medications, see doctors, handle stress, deal with the stigma -- and advocate in the community.
The study consists of interviews with more than 150 women who are HIV positive, an in-depth ethnography following 35 women over two years and a survey of service providers and organizations across Chicago who aid low-income individuals in gaining resources needed to live with the disease.
When complete, Watkins-Hayes hopes to outline the kind of economic strategies that are necessary to produce desired outcomes for both women's health and their upward social mobility. This work has clear policy and programmatic implications. She is interested in how these women are managing their lives in the face of serious obstacles, as the lessons learned can directly and indirectly help to stem the tide of the disease, she said.
Watkins-Hayes also dealt with navigation of resources in her new book "The New Welfare Bureaucrats: Entanglements of Race, Class, and Policy Reform." The book is based on her research on the changing job description of welfare case workers since the 1996 Personal Responsibility and Work Opportunity Reconciliation Act.
Welfare policy shifted to include time limits, a more aggressive work requirement and an overall emphasis on efficiency. "Resources are largely doled out through benchmarking instead of through holistic intervention to help people gain more resources, skills and education to be economically independent," Watkins-Hayes said.
"In both my welfare and HIV research, I'm interested in the public policies that shape the organizations charged with aiding disadvantaged people. For many, these institutions are incredibly important to everyday survival and have the potential to encourage socioeconomic mobility if organized and leveraged properly."
Watkins-Hayes' passion for her research extends beyond the classroom as she serves on the boards for Test Positive Aware Network, an HIV social service agency, and Spelman College, her alma mater.
"It is important to me that I am not simply an observer of the social issues that I care so deeply about but also an active participant in helping to improve them," she said.
Watkins-Hayes joined the Northwestern faculty in 2003. She is a member of Cells to Society (C2S): The Center on Social Disparities and Health, part of Northwestern's Institute for Policy Research.
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