Study Shows Impact of Safety Net Programs on Mental Health During COVID
By Christa Ishimwe
A recent Emory-led study shows that increased access to Temporary Assistance for Needy Families (TANF) during the COVID-19 pandemic was associated with reduced poor mental and physical health. TANF is a federal program that provides primary cash assistance to low-income individuals and is typically conditional on employment. At the height of COVID-19, several states relaxed their TANF eligibility rules to increase access to aid and mitigate the economic impacts of the pandemic. This study examined seven such policy changes and found evidence of associated stress-related health benefits. The authors of the paper include Emily Dore, PhD candidate in Sociology, and Melvin D. Livingston, PhD, associate professor at Rollins.
Using TANF policy data and data from the Behavioral Risk Factor Surveillance System from January 2017–December 2020, the researchers looked at the association between TANF policy changes and three stress-related health outcomes: physically unhealthy days, mentally unhealthy days, and binge drinking. Policy changes included emergency cash benefits to those not already participating in TANF, waiving work requirements, waiving or pausing actions, and automatically re-certifying TANF benefits.
“In general, we found that the more generous and the less restrictive the policies, the better the health outcome,” says Dore.
Supportive TANF changes were found to have a generally protective effect on reduced self-reported mentally and physically unhealthy days for likely TANF participants. The policy change most strongly associated with all three health outcomes was the provision of emergency cash benefits for those not already participating in TANF. "These findings matter because they lend support to the idea that the more generous social safety net, and the less burdensome it is to receive the benefits, the better the health outcomes for low-income populations,” says Dore.
Results regarding binge drinking as a health outcome were mixed, as waiving or pausing TANF was associated with increases in binge drinking. However, the authors explain that this was likely driven by external influence from non-TANF participants than the policy itself.
Since the study was conducted, some states have reverted to their pre-pandemic TANF polices. The findings of this study provide support for increasing the generosity of safety-net programs and continuing to ease their administrative burdens to mitigate negative health outcomes associated with economic crises.
“While the policies we studied were temporary changes due to the COVID pandemic, our results demonstrate that existing state programs have the infrastructure in place to meaningfully reduce poverty-driven health outcomes. We just have to be willing to make these kinds of reforms permanent,” says Livingston.