The effect of welfare reform on the health of the unemployed

Evidence from a natural experiment in Germany

Dados Bibliográficos

ID11174635
AutoresFaraz Vahid Shahidi (0000-0002-2789-1515, University of Toronto, autor correspondente), Carles Muntaner (0000-0003-3535-467X, University of Toronto), Ketan Shankarda (0000-0002-8410-2201, University of Toronto), Ketan Shankardass, Carlos Quiñonez (0000-0002-8311-3056, University of Toronto), Arjumand Siddiqi (0000-0002-2458-9011, University of Toronto)
Ano2020
Volume74
Fascículo3
Páginas211-218
Data de publicação2020-03-01
Peer ReviewedSim
Open AccessNão
TipoARTICLE
PeriódicoJournal of Epidemiology and Community Health (JOURNAL)
Identificadores do periódicoISSN: 0143-005X • E-ISSN: 1470-2738
EditoraBMJ (PUBLISHER • GB)
DOI10.1136/jech-2019-213151
PMID31915239
OpenAlexW3000215940
IdiomaEN
Citações recebidas2
Referências citadas39

BACKGROUND: Over the past several decades, governments have enacted far-reaching reforms aimed at reducing the generosity and coverage of welfare benefits. Prior literature suggests that these policy measures may have deleterious effects on the health of populations. In this study, we evaluate the impact of one of the largest welfare reforms in recent history-the 2005 Hartz IV reform in Germany-with a focus on estimating its effect on the health of the unemployed. METHODS: We employed a quasi-experimental difference-in-differences (DID) design using population-based data from the German Socio-Economic Panel Study, covering the period between 1994 and 2016. We applied DID linear probability modelling to examine the association between the Hartz IV reform and poor self-rated health, adjusting for a range of demographic and socioeconomic confounders. RESULTS: The Hartz IV reform was associated with a 3.6 (95% CI 0.9 to 6.2) percentage point increase in the prevalence of poor self-rated health among unemployed persons affected by the reform relative to similar but unaffected controls. This negative association appeared immediately following the implementation of the reform and has persisted over time. CONCLUSION: Governments in numerous European and North American jurisdictions have introduced measures to further diminish the generosity and coverage of welfare benefits. In line with growing concerns over the potential consequences of austerity and associated policy measures, our findings suggest that these reform efforts pose a threat to the health of socioeconomically disadvantaged populations

Demographic economics · Economics · Labour economics · Market economy · Natural (archaeology) · Natural experiment · Welfare · Welfare reform · Employment and Welfare Studies · Health disparities and outcomes · History · Medicine · Social Policy and Reform Studies