Even welfare programs that set out to do something as fundamental as feed the hungry and have been running apparently successfully for 30 or 40 years will sometimes struggle if called upon to demonstrate just how they benefit the populations they serve.
Do they work? Do participants become healthier? Might they have other positive, indirect effects such as reducing the abuse and neglect of children?
The questions may be obvious but so is the ethical difficulty of making comparisons between those who get food aid and those who do not. And there are other methodological problems to do with selection: people who go to the trouble to apply for assistance might have healthier children to begin with than families who are less organized and do not apply.
Two major US federal welfare programs, The Food Stamp Program (FSP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) have lately subjected themselves to the scrutiny of researchers from the Chapin Hall Center for Children at the University of Chicago.
FSP, which began in the 1960s, provides poor families with cards to purchase nutritious food, while WIC, which began in the 1970s, provides low-income women, infants, and children with nutritious foods to supplement diets, information on healthy eating, and referrals to health care. Over the years, researchers generally have concluded that these program work and that participants are generally in better health than people with similar circumstances who do not participate. But how to prove it?
Bong Joo Lee and Lucy Mackey-Bilaver, the authors of the article Children and Youth Services Review, got around the problem of selection bias by comparing children who received assistance to their siblings who did not. Because the family backgrounds of participants and non-participants were the same, any differences in their health could be more confidently attributed to the aid programs. They also considered whether participating parents were less likely to abuse or neglect their children because the assistance helped to reduce the stress they felt about providing food for their families.
The researchers examined government records of over 36,000 Illinois children from low-income families who were born between 1990 and 1996. They tracked their participation in FSP and WIC, their health status, and their exposure to abuse or neglect up to the age of five.
They found that the programs indeed had far-reaching effects. Children who received WIC or FSP, jointly or alone, consistently had lower rates of anemia, failure to thrive, and nutritional deficiency than their sibilings who received no services. Additionally, siblings who did not receive either service experienced more abuse/neglect than those who did get FSP and/or WIC assistance. The research, thus, suggests that nutrition programs can have positive unintended consequences.