Receiving Welfare Benefits Research Articles

Return to Work after Primary Total Knee Arthroplasty: The First Polish Pilot Retrospective Study.

(1) Background: Total knee arthroplasty (TKA) performed on working-age patients significantly affects the participation of such patients in social life. A retrospective study was conducted to determine the return to work (RTW) rate after TKA. The goal of this study was to provide reference data for the Polish population and identify the factors impacting patients' decisions to return to or resign from work, relative to their functional performance. (2) Methods: This retrospective study involved 48 patients. An interview related to RTW was carried out to identify the factors impacting a patient's decision to return to or resign from work. Functional performance was assessed using the Knee Outcome Survey-Activities of Daily Living (KOS-ADL) scale. (3) Results: Before TKA, 15 individuals (31.25%) qualified for the study did not work and were receiving welfare benefits. After the surgery, 23 individuals (47.9% of those working prior to TKA) did not return to work. The number of those who did not work after TKA increased to 38 (79.17%), which was a significant change. The mean level of functional performance after TKA assessed using KOS-ADL was 75.89. (4) Conclusions: The findings show that the rate of RTW after TKA in Poland is significantly lower than that in other countries. The reasons for this situation, as shown in the study, may be related to the lack of an occupational rehabilitation system, resulting in a paucity of information about the possibility to return to work and about opportunities for retraining.

Reflection on action by activation workers as professional learning strategy

ABSTRACT In this article, social work theory on reflective practice is used to explore the potential value of reflection on action for professional learning by activation workers who support people receiving welfare benefits to find work. The article focuses on the role of reflection on action in professional learning concerning three challenges which activation workers face: dealing with normative dilemmas, translating formal and informal knowledge into decision-making and dealing with power relations. The article presents tentative findings stemming from qualitative research on Dutch activation workers participating in reflection on action. Participants report multiple learning outcomes concerning these challenges. The theoretical and empirical exploration suggests that reflection on action can support learning by activation workers to better deal with professional challenges inherent to their work. However, these empirical findings are preliminary and based on a specific context. Further exploration by both scholars and practitioners is therefore suggested, in which the social work profession has a lot to offer.

Education and employment status among young adults three years after entering residential substance use treatment. A longitudinal data-linkage study

ABSTRACT Aims This study aims to investigate three-year follow-up among young adults who entered residential substance use disorder (SUD) treatment with regard to outcomes related to education, work and mortality. Methods Participants who entered residential SUD treatment between 2011 and 2016 aged 16–29 years were included in the study. In this study, we used data from the electronic health records of the treatment facility of the participants and linked these with data from nationwide registries. The data included de-identified, person-level information on patient demographics, crime, treatment use and socioeconomic factors. The primary outcome was education and employment status, analyzed using logistic regression. Results At the follow-up, two-fifths of the sample were in education or employment, half were receiving welfare benefits and the annual income level was low. 3.6% of the sample had died. Those who were in education or work were less likely to have post-treatment convictions and to use residential SUD treatment services than those who were not. Conclusion Being in education or employment and not engaging in crime or severe substance use can create a life situation that helps to sustain recovery. There is a need to establish SUD treatment for young adults that includes education- and employment-focused interventions.

Efficacy of mindfulness and goal setting interventions for increasing resilience and reducing smoking in lower socio-economic groups: randomised controlled trial protocol

BackgroundSmoking and resulting health problems disproportionately impact low socioeconomic status (SES) individuals. Building resilience presents an approach to ‘closing the gap’. Mindfulness-based interventions and setting realistic goals are preferred in low socioeconomic communities. We aim to test if these interventions, delivered online and consolidated with peer support offered via ex-smokers, are successful in promoting smoking cessation and resilience. Our conceptualisation of resilience encompasses the inner capacity/skills and external resources (e.g., social support) which smokers utilise to bounce back from adversity. We include a process evaluation of barriers/facilitators to interventions and cost-effectiveness analysis (from health system perspective).MethodsWe plan a four-arm parallel 12-month RCT with a 6-month follow-up to test the efficacy of three group-based interventions each followed by peer support. Arm 1: mindfulness-integrated cognitive behavioural therapy; Arm 2: mindfulness training; Arm 3: setting realistic goals; Arm 4: active control group directed to quit services. All interventions will be administered online. Participants are adult smokers in Australia (N = 812) who have an average weekly household income less than $457AUD or receive welfare benefits. Group-based interventions will occur over 6 months, followed by 6 months of forum-based peer support. Primary outcome: self-reported 14-day period prevalence of smoking abstinence at 6 months, with remote biochemical verification of saliva cotinine (< 30 ng/mL). Secondary outcomes include: internal resilience (Connor-Davidson Resilience Scale-25); external resilience (ENRICHD social support tool); quality adjusted life years (EQ-5D-5L); self-efficacy for smoking abstinence (Smoking-Abstinence Self-Efficacy Questionnaire); motivation to quit smoking (Biener and Abrams Contemplation Ladder); nicotine dependence (Fagerstrom Test for Nicotine Dependency); equanimity (Equanimity Scale-16); stress (Perceived Stress Scale-10); goal assessment/attainment (Problems and Goals Assessment Scale).DiscussionThis study is the first to compare resilience interventions for low SES smokers which have been identified by them as acceptable. Our various repeated measures and process evaluation will facilitate exploration of mechanisms of impact. We intervene within the novel framework of the Psychosocial Model of Resilience, applying a promising paradigm to address a critical and inequitable public health problem.Trial registration Australian New Zealand Clinical Trials Registry ID: ACTRN12621000445875, registered 19 April 2021 (https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=381007&isReview=true). The Universal Trial Number is U1111-1261–8951

Clinical Research Updates.

Clinical Research Updates.

Justice perceptions of sanctions for unemployed welfare recipients

Institutions of the welfare state are supposed to function in accordance with normative principles of redistributive justice, which should guide not only the allocation but also the withdrawal of resources. Our study examines justice assessments of sanctions for unemployed individuals receiving welfare benefits, a much-discussed variant of benefit withdrawal. We present results from a factorial survey that asked German citizens to indicate which sanction they would perceive as just under different scenarios. In particular, we look at different kinds of deviant behavior on the part of the unemployed job seeker, which allows for a broad picture concerning potential sanction-triggering events. The findings show that the extent of sanctions perceived as just varies considerably across scenarios. Respondents would impose more sanctions on men, repeaters, and young people. Moreover, they have a clear picture of the severity of the deviant behavior.

Psychotic Disorders in Adolescence and Later Long-term Exclusion From Education and Employment.

Psychotic disorders have been associated with not being in education, employment, and training (NEET). There is a lack of knowledge on the importance of risk markers for NEET among people with psychotic disorders and what rehabilitation they receive. We based our research on the register-based 1987 Finnish Birth Cohort study, which included all live births in Finland during that year. The study cohort were 288 people who had been diagnosed with psychotic disorders during 2004-2007, when they were 16-20 year old, and 55 883 who had not. We looked at the national register data for those subjects in 2008-2015, when they were 20-28 year old, and compared any associations between sociodemographic factors and NEET status. NEET for more than 5 year affected 2.2% of those without psychosis, 35.8% of those with any nonaffective psychotic disorder, and 57.0% of those with schizophrenia or schizoaffective disorders. Family-related risk factors were weaker predictors of long-term NEET in subjects with psychotic disorders than other cohort members. Having a psychotic disorder plus long-term NEET was associated with not applying for upper secondary education, not finishing upper secondary education, parents receiving welfare benefits, being diagnosed with schizophrenia or schizoaffective disorders and being hospitalized for psychosis. Only 24.3% with psychotic disorders had participated in vocational rehabilitation. A diagnosis of psychosis in adolescence is independently associated with serious long term functional disability. Among those with psychotic disorders, educational problems are markers for adverse labor market outcomes. Despite this, vocational rehabilitation is seldom provided.

Misperceptions about Refugee Policy

This letter explores the prevalence of misperceptions about refugee policy and tests whether correcting these misperceptions changes attitudes toward refugees. Large numbers of people hold misperceptions about both the nature and effects of refugee policy. An experiment directly compares the effects of correcting misperceptions about existing refugee policy (e.g., the refugee admission process) with correcting misperceptions about the outcomes of refugee policy (e.g., the proportion of refugees in the United States and the percentage who receive welfare benefits). Corrective information about existing policy substantially increases support for refugees, but corrective information about policy outcomes has no effect on attitudes. The results suggest that including descriptive information about existing U.S. policy in media coverage of refugees could both correct misperceptions and change attitudes.

Of ‘Welfare Queens’ and ‘Poor Carinas’: Social Constructions, Deservingness Messaging and the Mental Health of Welfare Clients

AbstractPoliticians engage in, and the media amplifies, social constructions of welfare recipients as undeserving. Such messaging seeks to influence mass public opinion, but what are the effects on the target population receiving welfare benefits? We test if deservingness messaging affects welfare recipients' mental health. To do so, we exploit a quasi-experiment entailing a dramatic shift in deservingness messaging after a welfare recipient in Denmark became the subject of a national debate, utilizing detailed administrative data on the ensuing consumption of antidepressants by other welfare recipients. We find evidence that welfare recipients experienced worse mental health outcomes after being exposed to deservingness messaging, reflected in a 1.2-percentage-point increase in the use of antidepressants in the weeks following the airing of a critical interview. Deservingness messaging particularly affected more vulnerable groups who had a history of mental health problems.

Cannabis and Tobacco Use Among Young People and Labor Market Outcomes in Midlife: A 23-Year Population-Based Longitudinal Study.

Research suggests an association between cannabis use and adverse labor market outcomes, but the mechanisms are unknown. We studied the nature of this association by comparing the relative roles of cannabis and tobacco use in predicting midlife outcomes. We analyzed data from the Young in Norway Study, a 23-year longitudinal investigation (N = 2,550; 56% female). Cannabis and tobacco use, potential confounders, and mediators were assessed by self-report. We used register data on income, years Not in Education, Employment or Training (NEET), and welfare benefits. We compared cannabis users (7%) and regular tobacco users (15%) with nonusers. After confounders were controlled for, cannabis users had lower income (income decile difference = -1.31; 95% CI [-1.83, -0.80]), had more NEET years (incidence rate ratio [IRR] = 1.87; 95% CI [1.34, 2.61]), and received welfare benefits more often (odds ratio [OR] = 2.84; 95 % CI [1.56, 5.17]). Tobacco users also earned less (income decile difference = -0.51; 95% CI [-0.86, -0.17]) and received welfare benefits more often (OR = 1.74; 95 % CI [1.14, 2.66]) but did not have more NEET years (IRR = 1.22; 95% CI [0.94, 1.59]). The reduction when controlling for confounders was larger for tobacco than for cannabis. Including mediators further reduced the associations for tobacco use considerably, whereas only slight reductions were observed for cannabis. The robust associations of cannabis use with poor labor market outcomes, even after adjustments, seem to differ from how tobacco use is related to such outcomes. More knowledge is needed about causal effects of cannabis use on important life domains.

“I Have Always thought that, If I Am Poor, I’m Also Supposed to Study Poorly”

The goal of this study is to highlight the embodied nature of social class inequalities in education. Drawing from a larger study that examined educational outcomes and work careers of young people whose families received welfare benefits in Croatia when these individuals were of high school age, the article focuses on biographical narrative interviews with three young individuals. These strategically selected cases were characterized by a shared experience of living in poverty that was, nevertheless, marked by very different initial intersections of social advantages and disadvantages (middle-class fall into poverty, intergenerational poverty, and poverty intersecting with anti-Roma racism). Based on the comparison of these three life stories, this study utilizes Bourdieu’s concept of habitus as a conceptual tool, incorporating both cognitive and affective schemas, to examine how these young individuals framed their lives and educational trajectories. In doing so, this study builds on the work by scholars such as Reay who extend the explorations of embodied social inequalities in education into the realm of emotions, which are—in line with the growing body of work in the sociology of emotions—understood as embedded in (unequal) social relations. Therefore, the analysis of this study focuses on how, in the three examined life stories, the horizons of probable, possible, and unimaginable were perceived very differently and shaped by distinct affective structures. The findings of this study suggest that cognitive and affective schemas function jointly, as integral elements of a social inequalities’ mechanism rooted in the compounding of advantages or disadvantages.

Implementing individual placement and support (IPS): the experiences of employment specialists in the early implementation phase of IPS in Northern Norway. The IPSNOR study

BackgroundFor decades there has been a continuous increase in the number of people receiving welfare benefits for being outside the work force due to mental illness. There is sufficient evidence for the efficacy of Individual Placement and Support (IPS) for gaining and maintaining competitive employment. Yet, IPS is still not implemented as routine practice in public community mental health services. Knowledge about implementation challenges as experienced by the practitioners is limited. This study seeks to explore the experiences of the front-line workers, known as employment specialists, in the early implementation phase.MethodsQualitative data were collected through field notes and five focus group interviews. The study participants were 45 IPS employment specialists located at 14 different sites in Northern Norway. Transcripts and field notes were analysed by thematic analyses.ResultsWhile employment specialists are key to the implementation process, implementing IPS requires more than creating and filling the role of the employment specialist. It requires adjustments in multiple organisations. The new employment specialist then is a pioneer of service development. Some employment specialists found this a difficult challenge, and one that did not correspond to their expectations going into this role. Others appreciated the pioneering role. IPS implementation also challenged the delegation of roles and responsibilities between sectors, and related legal frameworks related to confidentiality and access. The facilitating role of human relationships emphasised the importance of social support which is an important factor in a healthy work environment. Rural areas with long distances and close- knit societies may cause challenges for implementation.ConclusionThe study provides increased understanding on what happens in the early implementation phase of IPS from the employment specialists’ perspective. Results from this study can contribute to increased focus on job satisfaction, turnover and recruitment of employment specialists, factors which have previously been shown to influence the success of IPS. The greatest challenge for making “IPS efficacy in trials” become “IPS effectiveness in the real world” is implementation, and this study has highlighted some of the implementation issues.

Profiles of Resilience among Children Exposed to Non-Maltreatment Adverse Childhood Experiences.

Considering the high prevalence and negative consequences of non-maltreatment adverse childhood experiences (NM-ACEs), it is critical to understand their impacts on the resilient functioning of young children. This study sought to examine heterogeneity in resilience among first-grade children who were exposed to NM-ACEs during kindergarten and explore demographic and adversity characteristics that distinguish between resilience profiles. Latent profile analysis (LPA) was conducted on 4929 children drawn from the Early Childhood Longitudinal Study—Kindergarten (ECLS-K). The results of the LPA revealed four distinct resilience profiles: (1) low cognitive and executive functioning (4%); (2) low social and behavioral functioning (14%); (3) low average functioning (31%); and (4) multi-domain resilience (51%). Female children and those in families characterized by older maternal age, higher parental education level, household income above 200% federal poverty level, not receiving welfare benefits, and races other than Black were more likely to be in the multi-domain resilience profile. The findings highlight heterogeneity in resilience among children exposed to NM-ACEs and point to the need for a comprehensive, multi-domain assessment of child functioning to support optimal resilience development in this population.

Prevalence of depression in women with low income living in developed countries.

To conduct a systematic review of studies reporting prevalence rates of depression in women living in low-income circumstances in developed countries. The published and unpublished literature was searched for studies reporting prevalence of depression in women with low income in developed countries. Searches, data extraction, and methodological appraisal were conducted twice independently. To perform the analysis, the meta and metafor packages in R, a random effect model to account for both between and within studies' variances, and the restricted maximum likelihood method for estimation were used. One-hundred sixty-four studies, involving 218,035 participants, were located through the search process. The point prevalence of depression among women in low-income circumstances using self-report instruments in 134 studies was 37.4% (95% CI, 34.0%-40.7%). Additionally, the point prevalence according to depression diagnosis in 25 studies was 22.9% (95% CI, 17.8%-28.5%). The high rate of depression among women living in low-income circumstances is of serious public health concern. Women living in low-income circumstances should receive screening and referral/treatment in not only medical service settings, but also in social service settings serving women receiving welfare benefits.

Identifying trends over time in food affordability: The Illawarra Healthy Food Basket survey, 2011-2019.

To determine the affordability of a healthy food basket (HFB) for welfare recipients and average income earners in 2019 and to compare trends from 2011. Fifty-seven food items' prices were collected from fifteen stores across five suburbs representing low, medium and high socio-economic status. Costs were compared with average weekly income and welfare payments to assess the baskets' affordability for a family of four and five. In 2019, a HFB was affordable (below 30% of household income) for a five-person reference family with a pensioner, representing 24.8% of weekly welfare payments, but not for a four-person reference family (33.0%). The cost of the HFB increasedslightly over time from AU$288.91 in 2011to AU$291.79 in 2019. The food affordability improved for a family of five including a pensioner over this period due to an increase of average weekly earnings and welfare payments. In 2019, the HFB was affordable for a five-person family; however, a four-person family receiving welfare benefits would have experienced significant "food stress," with the food basket costing above 30% of household income. Inequity in the affordability of healthy food is a major public health concern and one that demands recognition and national action. The impact of policies affecting welfare support and wages needs to be considered, as well as food pricing strategies and possible food subsidies for those at greatest risk of food insecurity.

Ten years later: Self‐sufficiency of welfare mothers before the Great Recession

AbstractThis paper presents a preliminary evaluation of the Temporary Assistance to Needy Families program, that was mandated by the 1996 Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA), showing trends over time in wages for mothers who received welfare benefits in 1996, using the power of a longitudinal data set: a nationally representative sample of 1000 welfare mothers in the 1996 Survey of Income and Program Participation (SIPP), linked to their IRS wage records from 1996 to 2007. Only one in ten of the 1996 cohort of welfare mothers received wages that were at least 175% of the poverty line by 2007. By 2007, only one in six of those with more than a high school diploma achieved this level of economic self‐sufficiency. For all time periods, the federal Earned Income Tax Credit, had a positive impact for only the lowest wage earners, that is, with earnings below half the poverty line. Our results provide a commentary on the validity of neoliberal assumptions underlying the long‐term implementation of the PRWORA. Analyses of future SIPP panels will determine whether these trends continued.

Prevalence of Parental Alcohol Problems among a General Population Sample of 28,047 Norwegian Adults: Evidence for a Socioeconomic Gradient.

The aim of the study presented here was to estimate the prevalence of parental alcohol problems during childhood in a general population of Norwegian adults, and to investigate associations between parental alcohol problems during childhood and lower socioeconomic status in adulthood. This cross-sectional study recruited 28,047 adults (≥18 years) to an online health survey (Norwegian Counties Public Health Surveys). We evaluated demographic and socioeconomic measures and responses to a shortened version of the Children of Alcoholics Screening Test (CAST-6) scale to assess whether respondents perceived parental alcohol consumption during childhood as problematic. Respondents reported parental alcohol problems at a rate of 15.6%, but the experience was more prevalent among adults with a low education (20.0%), compared to those with intermediate (16.4%) or high educations (13.8%, χ2(2) = 87.486, p < 0.001), and it was more common among respondents with low economic capabilities (21.1%) compared to those with middle/high capabilities (14.2%, χ2(1) = 162.089, p < 0.001). Parental alcohol problems were most prevalent among respondents that received welfare benefits (24.5%). Multivariable logistic regression analyses revealed associations between parental alcohol problems and low socioeconomic status in adulthood; odds ratios (95% confidence intervals) ranged from 1.33 (1.25–1.42) to 1.89 (1.72–2.06). From a public health perspective, children who grow up with parental alcohol problems should be reached through both universal and selective interventions.

Excess mortality in patients with schizophrenia spectrum disorders in Malaga (Spain): A cohort study.

There is evidence that patients with schizophrenia spectrum disorders present higher mortality in comparison with the general population. The aim of this study was to analyse the causes of mortality and sociodemographic factors associated with mortality, standardised mortality ratios (SMRs), life expectancy and potential years of life lost (YLL) in patients with schizophrenia spectrum disorders in Spain. The study included a cohort of patients from the Malaga Schizophrenia Case Register (1418 patients; 907 males; average age 42.31 years) who were followed up for a minimum of 10 years (median = 13.43). The factors associated with mortality were analysed with a survival analysis using Cox's proportional hazards regression model. The main causes of mortality in the cohort were circulatory disease (21.45%), cancer (17.09%) and suicide (13.09%). The SMR of the cohort was more than threefold that of the population of Malaga (3.19). The life expectancy at birth was 67.11 years old, which is more than 13 years shorter than that of the population of Malaga. The YLL was 20.74. The variables associated with a higher risk of mortality were age [adjusted hazard ratio (AHR) = 1.069, p < 0.001], male gender (AHR = 1.751, p < 0.001) and type of area of residence (p = 0.028; deprived urban zone v. non-deprived urban area, AHR = 1.460, p = 0.028). In addition, receiving welfare benefit status in comparison with employed status (AHR = 1.940, p = 0.008) was associated with increased mortality. There is excess mortality in patients with schizophrenia spectrum disorders and also an association with age, gender, socioeconomic inequalities and receiving welfare benefits. Efforts directed towards improved living conditions could have a positive effect on reducing mortality.

Why Do Policymakers Support Administrative Burdens? The Roles of Deservingness, Political Ideology, and Personal Experience

AbstractAdministrative burdens affect peoples’ experience of public administration but there is, to date, limited evidence to as why policymakers are willing to accept and impose burdens. To address this gap, we draw from the policy design and administrative burden literatures to develop the concept of burden tolerance—the willingness of policymakers and people more generally to passively allow or actively impose state actions that result in others experiencing administrative burdens. Drawing on a survey experiment and observational data with Danish local politicians in a social welfare setting, we find that more right-wing politicians are more tolerant of burdens, but politicians are less willing to impose burdens on a welfare claimant perceived as being more deserving. Politicians with a personal experience of receiving welfare benefits themselves are less tolerant of burdens, while information about the psychological costs experienced by claimants did not reduce burden tolerance.

Trends Over Time in Employment for Mothers Who Received Welfare Benefits in 1996

Welfare reform brought on by the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996 has been the object of considerable debate and scholarship. This article shows impact over time in employment for a nationally representative sample of welfare mothers who received welfare benefits in 1996, using the 1996 Survey of Income and Program Participation (SIPP), linked to 10 years of their IRS wage records. In 1996, nearly half of them worked for wages. The vast majority had attained a high school diploma or less. Almost a fifth reported a severe disability and either fair or poor health. In 1997, the PRWORA was implemented for the entire U.S. That year, nearly three‐fifths had paid employment. Nearly three‐quarters received wages by 2000. After the recession of 2001, receipt of wages decreased. By 2007, receipt of wages was back to the 1997 level. Health, age, education, and work history of these mothers impacted receipt of wages as expected, but not car ownership and number of children. Our longitudinal data demonstrate the impact of business cycles as well as health, age, education, and work history to determine paid employment outcomes. Analyses of future SIPP panels will determine whether these trends continue.