Welfare-to-work interventions and their effects on the mental and physical health of lone parents and their children


Marcia Gibson1, Hilary Thomson1, Kasia Banas2, Vittoria Lutje3, Martin J McKee4, Susan P Martin1, Candida Fenton1, Clare Bambra5,  Lyndal Bond6

University of Glasgow, MRC/CSO Social and Public Health Sciences Unit, Glasgow, UK
University of Edinburgh, Department of Psychology, Edinburgh, UK
Liverpool School of Tropical Medicine, Department of Clinical Sciences, Liverpool, UK
Social Value Lab, Glasgow, UK
Newcastle University Medical School, Insitute of Health and Society, Newcastle upon Tyne, UK
Victoria University, College of Health and Biomedicine, Melbourne, Victoria, Australia

Gibson M, Thomson H, Banas K, Lutje V, McKee MJ, Martin SP, Fenton C, Bambra C, Bond L. Welfare-to-work interventions and their effects on the mental and physical health of lone parents and their children. Cochrane Database of Systematic Reviews 2017, Issue 8. Art. No.: CD009820. DOI: 10.1002/14651858.CD009820.pub2

Access the full-text article here: DOI/10.1002/14651858.CD009820.pub2/full

How do welfare-to-work interventions for lone parents affect adult and child health?

Lone parents in wealthy countries have disproportionately high levels of poverty and ill health. Governments argue that both poverty and health might improve if lone parents started working or worked more, while some researchers think that working at the same time as raising children alone could be stressful and make health worse.

Welfare-to-work interventions (WtW) are designed to either encourage or require lone parents to look for work. Earnings top-ups, stopping or reducing benefits, training, helping to pay for child care and limits on how long benefits are paid have all been used to try to increase lone parent employment. In order to understand how requiring lone parents to take part in WtW programmes affects their and their children's health, we systematically reviewed studies that collected information on these effects.

We found 12 studies involving 27,482 participants that compared groups of lone parents in WtW interventions with lone parents who continued to receive welfare benefits in the normal way. All of the studies were at high risk of bias because the staff who collected the data knew when respondents were in the intervention group. In some studies, lone parents who were not in the intervention group were affected by similar changes to welfare policy that applied to all lone parents. We used statistical techniques to combine the results of different studies.These analyses suggest that WtW does not have important effects on health. Employment and income were slightly higher 18 to 48 months after the start of the intervention, but there was little difference 49 to 72 months after the studies began. In a number of studies, lone parents who were not in WtW interventions found jobs by themselves over time. It is possible that effects on health were small because there was not much change in employment or income. Even when employment and income were higher for the lone parents in WtW, most participants continued to be poor. Perhaps because of this, depression also remained very high for lone parents whether they were in WtW or not.

All but one of the studies took place in the United States or Canada before the year 2000. This means it is difficult to be sure whether WtW would have the same effects in different countries at other times.