How Effective Are Different Welfare-to-Work Approaches? Five-Year Adult and Child Impacts for Eleven Programs. Health and Safety

12/01/2001

Impacts on measures of children's health and safety are shown in Table 12.4. The outcomes in this domain are available only from mothers' reports.

 

Table 12.4
Impacts on Health and Safety
Site and Program Sample Size Program Group Control Group Difference (Impact) Effect Size

General health rating (range of 1 to 5) (mother report)

Atlanta Labor Force Attachment 568 4.2 4.3 -0.0 -0.08
Atlanta Human Capital Development 641 4.3 4.3 0.1 0.09
Grand Rapids Labor Force Attachment 386 4.3 4.3 -0.1 -0.10
Grand Rapids Human Capital Development 365 4.3 4.3 0.0 0.07
Riverside Labor Force Attachment 473 4.2 4.3 -0.1 -0.11
Lacked high school diploma or basic skills 299 4.2 4.2 0.0 0.07
Riverside Human Capital Development 395 4.1 4.2 -0.1 -0.16

In very good or excellent health (%) (mother report)

Atlanta Labor Force Attachment 568 81.8 85.2 -3.4 -0.12
Atlanta Human Capital Development 641 83.6 85.8 -2.1 -0.07
Grand Rapids Labor Force Attachment 386 83.4 90.4 -7.0** -0.26
Grand Rapids Human Capital Development 365 87.0 90.1 -3.2 -0.12
Riverside Labor Force Attachment 473 85.7 87.6 -2.0 -0.07
Lacked high school diploma or basic skills 299 85.1 82.7 2.5 0.08
Riverside Human Capital Development 395 75.6 83.0 -7.4* -0.24

Has a physical, emotional, or mental condition that requires frequent medical attention, use of medication, or special equipment (%) (mother report)

Atlanta Labor Force Attachment 600 6.6 2.7 3.9** 0.30
Atlanta Human Capital Development 678 6.9 2.5 4.4*** 0.34
Grand Rapids Labor Force Attachment 428 13.6 12.8 0.8 0.02
Grand Rapids Human Capital Development 410 13.4 13.2 0.2 0.01
Riverside Labor Force Attachment 533 6.7 7.3 -0.6 -0.02
Lacked high school diploma or basic skills 338 6.3 6.5 -0.2 -0.01
Riverside Human Capital Development 438 6.5 6.8 -0.4 -0.02

Has a physical, emotional, or mental condition that impedes on mother's ability to go to work or school (%) (mother report)

Atlanta Labor Force Attachment 600 4.5 1.2 3.3** 0.34
Atlanta Human Capital Development 678 3.1 1.3 1.8 0.18
Grand Rapids Labor Force Attachment 428 6.4 8.1 -1.7 -0.07
Grand Rapids Human Capital Development 410 6.3 8.3 -2.0 -0.08
Riverside Labor Force Attachment 533 4.0 6.2 -2.2 -0.10
Lacked high school diploma or basic skills 338 3.1 5.0 -1.9 -0.10
Riverside Human Capital Development 438 5.3 5.2 0.1 0.01

Had an accident or injury requiring emergency medical attention, since the last interview (%) (mother report)

Atlanta Labor Force Attachment 600 15.7 16.4 -0.7 -0.02
Atlanta Human Capital Development 678 15.3 15.9 -0.6 -0.02
Grand Rapids Labor Force Attachment 428 26.3 23.6 2.7 0.07
Grand Rapids Human Capital Development 409 22.4 24.2 -1.8 -0.04
Riverside Labor Force Attachment 532 23.2 25.9 -2.7 -0.07
Lacked high school diploma or basic skills 337 20.9 21.2 -0.3 -0.01
Riverside Human Capital Development 435 20.4 21.6 -1.3 -0.04
SOURCE: Child Trends calculations from the Five-Year Child Outcomes Study survey (mother reports)
NOTES:  See Appendix A.2

The impacts in this domain of development were relatively few. There were no impacts on three of the six measures of health and safety, including mean levels of children's general health, as reported by mothers. Overall, the children in these sites seemed to be relatively healthy compared with children nationally. The proportion of control group children rated by their mothers as being in very good or excellent health ranged from 85 percent (in Atlanta) to 90 percent (in Grand Rapids). These levels are higher than the 1994 estimates from the National Health Interview Survey, in which 78.5 percent of all children aged 5 to 17 and 61.5 percent of those from families with annual incomes below $10,000 were rated by their parents as being in very good or excellent health.(22)

Yet where impacts were found (in four of the six programs) they were consistently unfavorable.(23) Two programs (Grand Rapids LFA and Riverside HCD) decreased the proportion of children reported as being in very good or excellent health, reducing these levels by about 7 percentage points. It is worth noting, however, that these unfavorable impacts resulted from program mothers being more likely than control group mothers to rate the focal child as being in good  not fair or poor  health. In addition, both Atlanta programs unfavorably affected two measures of health, increasing the proportion of children whose mothers reported that they had a physical, emotional, or mental condition that required frequent medical attention or the use of medication or special equipment and increasing the proportion with such a condition that impeded mothers' ability to go to work or school (although the difference for the HCD program on the latter measure was just beyond the cutoff for statistical significance). The impacts on conditions requiring frequent medical attention or the use of medication or special equipment were each about 4 percentage points. The impacts on conditions impeding the mothers' work or schooling were generally smaller, about 3 percentage points in the LFA program and about 2 percentage points in the HCD program. These health impacts may shed light on the unfavorable impacts on absenteeism and tardiness that were found in the Atlanta programs and in the Riverside HCD program. It is possible that the decreases in health status caused by these programs led to an increased likelihood of a child's being absent or tardy.