Vanessa Swain, age 13, has been battling juvenile arthritis (JA) since she was a toddler, and for most of her life, her mother has been by her side, helping her deal with every aspect of her condition.

“I was a stay-at-home mom for 10 years, so I was always with her, always the one to give her meds, always the caretaker,” Dana Swain says.

A lot of care has been required to manage Vanessa’s arthritis, including frequent doctor visits. And the mother daughter duo never missed an appointment – at least until last year, when the economic downturn hit home.

The Swains live in Michigan, which has one of the nation’s highest unemployment rates, due in great part to the contraction of the auto industry there.

Dana’s husband, Don, was one of many in the state who was laid off. 

With their income reduced, Dana was forced to work full-time and that doesn’t leave a lot of time to get Vanessa to her clinic visits.

“I only have a certain amount of days I can take off, and unfortunately, I am in the medical field at a cancer center and you can't just up and leave,” Swain says. “I’d be worried about getting written up,” she continues. “If [Vanessa] has to go, am I going to lose my job? And then what do you do? You’re back at square one.”

The family has had to reschedule several of Vanessa’s appointments in the last year, and her grandmother is now pitching in to help with transportation. But no matter the challenges, the family agrees on one thing.

“Her health is the most important thing,” Swain says. “We will make it work. It’s not always easy, but somehow we muddle through.”

Even with Insurance, Health Takes a Hit

The Swains aren’t the only ones feeling forced to make difficult decisions between health care and job security.

Rheumatologists say that as the economy took a downturn and unemployment skyrocketed, they expected patients to skip appointments because of lost health insurance or unwieldy transportation costs. And they have seen that.