Alcohol and Other Drug Treatment for Parents and Welfare Recepients: Outcomes, Costs and Benefits. 3. Characteristics of Treatment Subgroups

01/01/1997

Subgroup definitions and CALDATA population estimates

The major objective of this study is to analyze treatment outcomes of clients who were parents or received welfare income, and particularly the characteristics of women with dependent children. In order to interpret results for this group correctly, we also analyze and compare treatment population characteristics and histories prior to admission and at outcome for male clients, clients without children, clients with concerns related to children such as parenting and custody problems, and clients not receiving welfare income.

The definitions of subgroups of primary interest in this study are based on items contained in the CALDATA database and take into account the distribution of respondents among cross-classified subgroups, which are defined based on four main items:

  • Whether clients had children in their households in the year prior to entering treatment (47% of women, 29% of men in the CALDATA treatment population).
  • Whether clients received welfare income during the year prior to entering treatment (41% of women, 18% of men).
  • Whether clients reported that parenting concerns were an important reason for entering treatment (28% of women, 8% of men).
  • Whether clients reported losing custody of a child at any time prior to entering treatment (28% of women, 17% of men).

These distributions and some key cross-classifications are summarized in Figures 3.1, 3.2, and 3.3. (The estimated populations in these tables vary due to variations in the numbers of questions answered in interviews.) The pie charts for men and women are proportioned to reflect estimated numbers in the CALDATA treatment population.


Figure 3.1 CALDATA Treatment Population Estimates by
Gender, Children in Househod, and Welfare Recipt in Past Year

Figure 3.1 CALDATA Treatment Population Estimates by Gender, Children in Househod, and Welfare Recipt in Past Year

Source: NORC CALDATA


Of the treatment participants represented in the CALDATA sample:

  • Most treatment participants were men (62%).
  • A minority of the men admitted to treatment had children in their households in the year before treatment (29%) or had been on welfare during the year before treatment (18%).
  • Nearly half (47%) of women in treatment had children in their household in the year before admission, and 41 percent had received welfare payments during the year before admission.
  • Less than one-fourth of men in treatment with children received welfare payments, but nearly two-thirds of women in treatment with children received welfare payments.
  • The group reporting both welfare receipt and children in the household comprises about 30 percent of all women in treatment, although only about 11 percent of all treatment participants.

Women were not only more likely than men to have children in their household, but also much more likely to report parenting concerns as important reasons for treatment (see Figure 3.2).

  • The majority of women entering treatment (54%) had children in their household before entering treatment or reported parenting concerns as an important reason for treatment.

Figure 3.2 CALDATA Treatment Population by Gender,
Children in Household, and Parenting Concerns

Figure 3.2 CALDATA Treatment Population by Gender, Children in Household, and Parenting Concerns

Source: NORC CALDATA


Figure 3.3 CALDATA Treatment Population by Gender,
Children in Household, and Child Custody History

Figure 3.3 CALDATA Treatment Population by Gender, Children in Household, and Child Custody History

Source: NORC CALDATA


A similar proportion of men and women (12%) who no longer had children in the household had at some point before treatment lost custody of children. But a much greater percentage of women than men who had children in their household in the year before treatment had at some time lost custody of their children (14% versus 4%). The CALDATA questionnaire did not differentiate reasons for loss of custody, but this pattern suggests that the men mostly lost custody due to divorce or separation decrees and often on a permanent basis, while the women lost custody due to episodic inability or unwillingness to carry out parenting responsibilities, and that these episodes were often temporary and the custody losses reversible.

Altogether, women with children in the household who also received welfare income made up about 11 percent of the CALDATA population. A smaller percentage, about 6 percent, of the treatment clients were women with children who did not receive welfare income, and clients in the equivalent category for men made up 14 percent of the total treatment population. Looking at the categories of men and women who had neither children in the household, welfare income, nor other parenting concerns confirms the importance of gender in parenting concerns that was seen in the previous table. Men in this category without welfare income or parenting concerns comprised about 25 percent of the total treatment population while similar women make up only about 11 percent.

Demographic characteristics of CALDATA subgroups

The total treatment population was split nearly equally between white non-Hispanics and other ethnicities, but with a sex difference: 48 percent of the women and 59 percent of the men were black or Hispanic. Overall, clients with children in the household or receiving welfare before treatment were about ten percentage points more likely to be black and Hispanic than those without children or welfare receipt. Among women in the treatment population, 67 percent of those who both lived with children and received welfare were Hispanic or black, versus only 33 percent of those with neither welfare nor children. All major ethnic categories were about equally likely to have lost custody of children prior to treatment.

The men in treatment were on average somewhat older than the women. About 33 percent of men versus 22 percent of women were 40 years or older. There was little difference in the ages of men with or without children, welfare, or parenting concerns. Among the women, however, those with either children or welfare were appreciably younger on average than those without; only one out of nine women (11%) with both children and welfare were 40 years or older, versus one out of three women (33%) with neither children nor welfare. A similar gradient applied to type of treatment: 47 percent of the women with both children and welfare were in methadone, compared with 29 percent of women with neither children nor welfare.

Figure 3.4 presents employment and earnings characteristics of the different subgroups. Overall, men in treatment had significantly higher labor force participation than women 57 percent of men versus 39 percent of women earned wages from employment in the year before admission to treatment and that working men with children, especially those who did not receive any welfare income, had higher income than any other subgroup. The data also showed that a higher percentage of men in any of these subgroups received disability income than women, possibly because the route to receiving AFDC support and MediCal was much easier than that to receiving SSI or SSDI. Specific earnings figures were as follows:


Figure 3.4 CALDATA Treatment Population by Gender,
Percentage Employed, and Median Earnings

Figure 3.4 CALDATA Treatment Population by Gender, Percentage Employed, and Median Earnings

Source: NORC CALDATA


The use of particular types of drugs might be considered to have differential impacts on the ability to care for children, child safety, and need for income support. CALDATA respondents were asked to identify the main drug or drugs (about one-fourth of the treatment population identified two drugs or, in some cases, more) for which they entered treatment. Despite the enormous public concerns generated about the use of crack cocaine, this drug preparation was very far from dominating the treatment picture in California. As indicated in Table 2.1, the three most prevalent main drugs at admission, as identified by program records, were heroin, alcohol, and cocaine powder (that is, cocaine formulated for injection or snorting, rather than to be smoked). From the interviews, the following five drugs accounted for most of the main drugs mentioned: heroin, 48 percent; alcohol, 28 percent; cocaine powder, 17 percent; amphetamines, 13 percent; crack cocaine, 11 percent; all other drugs, 5 percent. There was little variation in main drug by sex, parenting status, or welfare receipt. The notable exception was crack; while 10 percent of all men and 11 percent of all women reported crack as main drug, it was reported as such by 25 percent of the women and 17 percent of the men who received welfare but were not living with children. This crack-dependent, welfare-but-no-children group comprises about 2 percent of the CALDATA treatment population.

Conclusion

We divided the CALDATA treatment population into substantial subgroups by attending to the clients' sex, parenting status, and welfare receipt. These groups diverged somewhat on other demographic and treatment-related characteristics. The women who received treatment were more likely than their male couterparts to have had children in their household, express parenting concerns as reasons for seeking treatment, and to have received welfare income prior to admission. Women who were in the children-and-welfare subgroup (the typical AFDC recipient) were much more likely to be Black or Hispanic than women with neither characteristic, and this subgroup was also more likely to be younger than 40, in methadone treatment, and in receipt of little or no wage earnings in the year prior to treatment. These differences indicate that women in treatment, like women in general, are more often child-oriented and economically dependent on income support programs than men, and that the women with both children and welfare are somewhat distinct from other women. Nevertheless, the difference seems to be more in degree than in kind. In the next two chapters, we will explore the results of treatment for these subgroups, exploring whether these conditions lead to any differences in the results of treatment for women in general and the parenting and welfare subgroups in particular.

  • A smaller percentage of men (33%) had children in their household before entering treatment or reported parenting concerns as an important reason for treatment.
  • Only one-sixth of the men who had children in their household reported parenting concerns as an important reason for treatment; however, about three out of seven women reported parenting concerns as an important reason for treatment.
  • Median earnings for the year among those who had been employed were low: $6,000 for men and $4,800 for women.
  • Men and women who received welfare benefits during the year were less often employed and earned far less income than those who were not on welfare.
  • About three-fourths of men with children and without welfare benefits were employed during the year before treatment, the highest percentage of any subgroup; this group of employed men earned the highest sums, a median of $11,850.