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BMC Public Health
Published in: BMC Public Health 1/2019

Open Access 01-12-2019 | Research article

The impact of social assistance programs on population health: a systematic review of research in high-income countries

Authors: Faraz V Shahidi, Chantel Ramraj, Odmaa Sod-Erdene, Vincent Hildebrand, Arjumand Siddiqi

Published in: BMC Public Health | Issue 1/2019

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Abstract

Background

Socioeconomic disadvantage is a fundamental cause of morbidity and mortality. One of the most important ways that governments buffer the adverse consequences of socioeconomic disadvantage is through the provision of social assistance. We conducted a systematic review of research examining the health impact of social assistance programs in high-income countries.

Methods

We systematically searched Embase, Medline, ProQuest, Scopus, and Web of Science from inception to December 2017 for peer-reviewed studies published in English-language journals. We identified empirical patterns through a qualitative synthesis of the evidence. We also evaluated the empirical rigour of the selected literature.

Results

Seventeen studies met our inclusion criteria. Thirteen descriptive studies rated as weak (n = 7), moderate (n = 4), and strong (n = 2) found that social assistance is associated with adverse health outcomes and that social assistance recipients exhibit worse health outcomes relative to non-recipients. Four experimental and quasi-experimental studies, all rated as strong (n = 4), found that efforts to limit the receipt of social assistance or reduce its generosity (also known as welfare reform) were associated with adverse health trends.

Conclusions

Evidence from the existing literature suggests that social assistance programs in high-income countries are failing to maintain the health of socioeconomically disadvantaged populations. These findings may in part reflect the influence of residual confounding due to unobserved characteristics that distinguish recipients from non-recipients. They may also indicate that the scope and generosity of existing programs are insufficient to offset the negative health consequences of severe socioeconomic disadvantage.
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Metadata
Title
The impact of social assistance programs on population health: a systematic review of research in high-income countries
Authors
Faraz V Shahidi
Chantel Ramraj
Odmaa Sod-Erdene
Vincent Hildebrand
Arjumand Siddiqi
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-018-6337-1

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