Unconditional cash transfers and maternal substance use: findings from a randomized control trial of low-income mothers with infants in the U.S.
Abstract Background Policy debates over anti-poverty programs are often marked by pernicious stereotypes suggesting that direct cash transfers to people residing in poverty encourage health-risking behaviors such as smoking, drinking, and other substance use. Causal evidence on this issue is limited...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-05-01
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| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-022-12989-1 |
| _version_ | 1817985452452347904 |
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| author | Paul Y. Yoo Greg J. Duncan Katherine Magnuson Nathan A. Fox Hirokazu Yoshikawa Sarah Halpern-Meekin Kimberly G. Noble |
| author_facet | Paul Y. Yoo Greg J. Duncan Katherine Magnuson Nathan A. Fox Hirokazu Yoshikawa Sarah Halpern-Meekin Kimberly G. Noble |
| author_sort | Paul Y. Yoo |
| collection | DOAJ |
| description | Abstract Background Policy debates over anti-poverty programs are often marked by pernicious stereotypes suggesting that direct cash transfers to people residing in poverty encourage health-risking behaviors such as smoking, drinking, and other substance use. Causal evidence on this issue is limited in the U.S. Given the prominent role of child allowances and other forms of cash assistance in the 2021 American Rescue Plan and proposed Build Back Better legislation, evidence on the extent to which a monthly unconditional cash gift changes substance use patterns among low-income mothers with infants warrants attention, particularly in the context of economic supports that can help improve early environments of children. Method We employ a multi-site, parallel-group, randomized control trial in which 1,000 low-income mothers in the U.S. with newborns were recruited from hospitals shortly after the infant’s birth and randomly assigned to receive either a substantial ($333) or a nominal ($20) monthly cash gift during the early years of the infant’s life. We estimate the effect of the unconditional cash transfer on self-report measures of maternal substance use (i.e., alcohol, cigarette, or opioid use) and household expenditures on alcohol and cigarettes after one year of cash gifts. Results The cash gift difference of $313 per month had small and statistically nonsignificant impacts on group differences in maternal reports of substance use and household expenditures on alcohol or cigarettes. Effect sizes ranged between − 0.067 standard deviations and + 0.072 standard deviations. The estimated share of the $313 group difference spent on alcohol and tobacco was less than 1%. Conclusions Our randomized control trial of monthly cash gifts to mothers with newborn infants finds that a cash gift difference of $313 per month did not significantly change maternal use of alcohol, cigarettes, or opioids or household expenditures on alcohol or cigarettes. Although the structure of our cash gifts differs somewhat from that of a government-provided child allowance, our null effect findings suggest that unconditional cash transfers aimed at families living in poverty are unlikely to induce large changes in substance use and expenditures by recipients. Trial Registration Registered on Clinical Trials.gov NCT03593356 in July of 2018. |
| first_indexed | 2024-04-13T23:57:34Z |
| format | Article |
| id | doaj.art-808c77c215824c17987228419d5763f7 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-04-13T23:57:34Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-808c77c215824c17987228419d5763f72022-12-22T02:23:49ZengBMCBMC Public Health1471-24582022-05-0122111110.1186/s12889-022-12989-1Unconditional cash transfers and maternal substance use: findings from a randomized control trial of low-income mothers with infants in the U.S.Paul Y. Yoo0Greg J. Duncan1Katherine Magnuson2Nathan A. Fox3Hirokazu Yoshikawa4Sarah Halpern-Meekin5Kimberly G. Noble6School of Education, University of California, IrvineSchool of Education, University of California, IrvineSandra Rosenbaum School of Social Work, University of Wisconsin-MadisonCollege of Education, University of Maryland, College ParkSteinhardt School of Culture, Education, and Human Development, New York UniversitySchool of Human Ecology & La Follette School of Public Affairs, University of Wisconsin-MadisonTeachers College, Columbia UniversityAbstract Background Policy debates over anti-poverty programs are often marked by pernicious stereotypes suggesting that direct cash transfers to people residing in poverty encourage health-risking behaviors such as smoking, drinking, and other substance use. Causal evidence on this issue is limited in the U.S. Given the prominent role of child allowances and other forms of cash assistance in the 2021 American Rescue Plan and proposed Build Back Better legislation, evidence on the extent to which a monthly unconditional cash gift changes substance use patterns among low-income mothers with infants warrants attention, particularly in the context of economic supports that can help improve early environments of children. Method We employ a multi-site, parallel-group, randomized control trial in which 1,000 low-income mothers in the U.S. with newborns were recruited from hospitals shortly after the infant’s birth and randomly assigned to receive either a substantial ($333) or a nominal ($20) monthly cash gift during the early years of the infant’s life. We estimate the effect of the unconditional cash transfer on self-report measures of maternal substance use (i.e., alcohol, cigarette, or opioid use) and household expenditures on alcohol and cigarettes after one year of cash gifts. Results The cash gift difference of $313 per month had small and statistically nonsignificant impacts on group differences in maternal reports of substance use and household expenditures on alcohol or cigarettes. Effect sizes ranged between − 0.067 standard deviations and + 0.072 standard deviations. The estimated share of the $313 group difference spent on alcohol and tobacco was less than 1%. Conclusions Our randomized control trial of monthly cash gifts to mothers with newborn infants finds that a cash gift difference of $313 per month did not significantly change maternal use of alcohol, cigarettes, or opioids or household expenditures on alcohol or cigarettes. Although the structure of our cash gifts differs somewhat from that of a government-provided child allowance, our null effect findings suggest that unconditional cash transfers aimed at families living in poverty are unlikely to induce large changes in substance use and expenditures by recipients. Trial Registration Registered on Clinical Trials.gov NCT03593356 in July of 2018.https://doi.org/10.1186/s12889-022-12989-1PovertyCash transferChild AllowanceSubstance useRandomized Control Trial |
| spellingShingle | Paul Y. Yoo Greg J. Duncan Katherine Magnuson Nathan A. Fox Hirokazu Yoshikawa Sarah Halpern-Meekin Kimberly G. Noble Unconditional cash transfers and maternal substance use: findings from a randomized control trial of low-income mothers with infants in the U.S. BMC Public Health Poverty Cash transfer Child Allowance Substance use Randomized Control Trial |
| title | Unconditional cash transfers and maternal substance use: findings from a randomized control trial of low-income mothers with infants in the U.S. |
| title_full | Unconditional cash transfers and maternal substance use: findings from a randomized control trial of low-income mothers with infants in the U.S. |
| title_fullStr | Unconditional cash transfers and maternal substance use: findings from a randomized control trial of low-income mothers with infants in the U.S. |
| title_full_unstemmed | Unconditional cash transfers and maternal substance use: findings from a randomized control trial of low-income mothers with infants in the U.S. |
| title_short | Unconditional cash transfers and maternal substance use: findings from a randomized control trial of low-income mothers with infants in the U.S. |
| title_sort | unconditional cash transfers and maternal substance use findings from a randomized control trial of low income mothers with infants in the u s |
| topic | Poverty Cash transfer Child Allowance Substance use Randomized Control Trial |
| url | https://doi.org/10.1186/s12889-022-12989-1 |
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