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Faculty Video Interview

Shirley L. Porterfield is a Professor in the School of Social Work, affiliated Professor in the Public Policy Administration program, and courtesy Professor in Economics at the University of Missouri-St. Louis.  She is a research affiliate in Washington University’s Center for Social Development and a member of the program committee for the Signature Health Foundation.  Dr. Porterfield teaches graduate-level courses in Program Evaluation and Health Care Policy. 

Dr. Porterfield, who received her Ph.D. in Agricultural and Applied Economics from the University of Wisconsin-Madison, focuses her research on health policy, and work, family, and retirement issues associated with disability in children and working-age adults, with particular emphasis on issues facing lower-income families. Her articles on these and other topics can be found in journals such as Pediatrics, the American Journal of Public Health, Journal of Marriage and the Family, Children and Youth Services Review, and Health Affairs.  Dr. Porterfield has received research funding from several sources, most recently the Health Resources and Services Administration (HRSA). 

Research Interests:

  • Children with Special Health Care Needs
  • Health Policy
  • Assets
  • Poverty
  • Retirement
  • Work-Family Issues

Teaching Interests:

  • Program Evaluation
  • Healthcare Policy


  • Ph.D., University of Wisconsin - Madison, 1988
  • MS, University of Arizona, 1984
  • BS, Oregon State University, 1982

Recent Publications

  • Recent Publications

    DeRigne, L., Porterfield, S.L., Quinn, L.M., Stoddard-Dare, P., Rong, B, & Collins, C.  2022.  Caregiving, health status, and total family net worth among men and women approaching retirement age.  Community, Work, and Family, in press.

    Background and Objectives: Building on opportunity cost theory and an understanding of how gender impacts household labor decisions, this study examines how family net worth may be

    impacted by three variables (having a work-limiting health condition, caregiving inside thehome, caregiving outside of the home) while controlling for demographic and employmentrelated

    variables for married and unmarried male and female caregivers.

    Research Design and Methods: This study uses a nationally representative sample of 5,173 older adults ages 51-60 from the 2016 round of 1979 National Longitudinal Survey of Youth


    Results: Findings from the weighted sample suggest having a limiting health condition is significantly and negatively related to total family net worth: people with a work limiting health

    condition experience a $55,000-$180,000 decline in total family net worth. Further, caregiving inside the home had a significant negative relationship with total family net worth for two

    subgroups: married males and unmarried females. Providing care to someone outside the home was significantly and positively related to total family net worth only for unmarried males.

    Discussion and Implications: Findings from this study reinforce the need for policies and programs to help employees manage their own health conditions and caregiving responsibilities for family members with financial preparedness for retirement.


    Guo, B., Huang, J., & Porterfield, S.L.  2020.  Food security and health in transition to adulthood for individuals with disabilities.  Disability and Health Journal, 13(4), 100937.

    Background: Due to a more stringent disability definition used for eligibility redetermination at age 18, individuals with disabilities may lose eligibility for the Supplement and Nutrition Assistance Program (SNAP).

    Objective: This study examines how the transition to adulthood may affect the association between food security and self-rated health and healthcare needs for individuals with disabilities.

    Methods: The study uses five years of data (2011-2015) from the National Health Interview Survey (NHIS). One health indicator, self-rated health status, and two indicators of unmet healthcare needs, delayed medical care and not receiving medical care due to cost, are analyzed as dependent variables. The effects of food security status on health and health-related outcomes are closely examined for the four groups: youth without disabilities, youth with disabilities, young adults without disabilities and young adults with disabilities.

    Results: Results indicate a statistically significant association between food security status and self-rated health and unmet healthcare needs in late childhood and young adulthood. Such association is stronger for young adults than for youth. The association between low food security and self-rated health and health-related outcomes does not significantly differ between the two youth groups or the two young adult groups by disability status.

    Conclusions: Suggestions for improving accessibility of public food and nutrition programs are discussed. The study also suggests the importance of creating a healthcare system that benefits every member of the society.


    Huang, J., & Porterfield, S.L. 2019. Changes in health insurance coverage and health care access as teens with disabilities transition to adulthood. Disability and Health Journal, 12, 551-556.


    Background: Pre-ACA, less than 6% of children with disabilities were uninsured, compared with more than 42% of young adults with disabilities ages 19-25. Individuals with disabilities face greater barriers to health care access upon transition into adulthood.

    Objectives: We examined whether the ACA dependent coverage provision and Medicaid expansion improved the transition from pediatric to adult healthcare systems by reducing the gap in insurance coverage and access to care between teens and young adults with disabilities.

    Methods: Using cross-sectional data from the 2006-2009 and 2011-2015 National Health Interview Survey (n=10,136), we estimate the change in insurance coverage and access to care from pre-to post- ACA time periods for teens (ages 13-18) and young adults (ages 19-25) with disabilities in a differencein-differences model.We completed the same analyses for these groups in Medicaid expansion and nonexpansion states.

    Results: Both teens and young adults with disabilities made significant gains in insurance coverage (4.55 and 8.96% point gains respectively, p < .001) and access to care (4.01 and 3.14% points decline in delayed care due to cost, p < .05) under the dependent coverage provision and Medicaid expansion.

    Conclusions: Medicaid expansion had a greater impact on both insurance coverage and on access to care than did the dependent coverage provision. The benefits of these changes flowed primarily to young adults with disabilities, reducing the gaps in insurance coverage between teens and young adults, and expanding access to care for both groups, providing a more seamless transition from pediatric to adult health care systems, post-ACA.



    SW 6400 – Practice and Program Evaluation
    SW 6443 – Health Care Policy