As some work themselves to death, the mere offer of job training may be enough to kill others.

A new study tracking Floridians over a generation on welfare showed a half-percent increase in the death rate for those pushed toward work with imposed limitations on social welfare benefits following the "third way" political compromise in 1996 between President Bill Clinton and Congressional republicans. With rhetoric of replacing the "bigotry of soft expectations," the Personal Responsibility and Work Opportunity Reconciliation Act supposedly "ended welfare as we know it," as Clinton famously put in his campaign promises.

Researchers from Columbia University sought to analyze the long-term health repercussions of the social experiment known as the "Florida Family Transition Program," which included a 24-36-month time limit for welfare benefits in that state, as well as intensive job training and placement assistance. Among more than 3,200 participants in the program linked to follow-up mortality data, the death rate was 16 percent higher than recipients of traditional welfare.

"The message of the finding is that there is a very small but statistically significant difference in the measured death rates between these two populations," Dr. Jan Blustein, a professor of health policy and medicine at New York University, who was not involved in the study, told reporters.

In the journal Health Affairs, lead investigator Peter Muennig, of Columbia University, writes that although researchers have examined links between social policy and health, few have looked at the outcomes of welfare reform in America. While research conducted during the late 1990s showed the policy changes effective in getting more people to work with greater earnings, little was known about health effects overall.

Among the 1,611 participants in the study group pressured to get jobs, 4.7 percent died by 2011, according to data from the U.S. Social Security Administration. Those deaths compared to 4.2 percent among the 1,613 people who remained on traditional social welfare, with no impetus to move into the workforce.

The slightly higher death rate may be explained by a split among some who successfully improved their lot with a new work life and others who "lost their lifeline and had to fall back on already poor family members and friends to eat and get shelter," Meunnig told reporters.

Although the program achieved the goal of moving welfare recipients toward greater independence, they failed as a group to significantly improve their economic status, making not much more money in the working world than from sources such as food stamps and other social welfare benefits. Moreover, half of those pushed toward work remained jobless during much of the program.

However, Bluestein noted that most of the welfare recipients in the study group were most likely to be single mothers, and that further research would be needed to clarify reasons for the higher death rate.

"I call this hypothesis generating," Bluestein said. "I don't think we should reform welfare again because it's causing higher deaths in women, but the study is intriguing and points to a possible connection between social policy and health."

The Columbia research team is presently investigating the mortality rate among children whose parents participated in the welfare-to-work program, and whether an increased death rate makes cost-benefit sense as public policy.

 

Source: Muennig, Peter, Rosen, Zohn, Wilde, Elizabeth Ty. Welfare Programs That Target Workforce Participation May Negatively Affect Mortality. Health Affairs. 2013.