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Policy Points The Paycheck Plus randomized controlled trial tested a fourfold increase in the Earned Income Tax Credit (EITC) for single adults without dependent children over 3 years in New York and Atlanta. In New York, the intervention improved economic, mental, and physical health outcomes. In Atlanta, it had no economic benefit or impact on physical health and may have worsened mental health. In Atlanta, tax filing and bonus receipt were lower than in the New York arm of the trial, which may explain the lack of economic benefits. Lower mental health scores in the treatment group were driven by disadvantaged men, and the study sample was in good mental health., Context: The Paycheck Plus experiment examined the effects of an enhanced Earned Income Tax Credit (EITC) for single adults on economic and health outcomes in Atlanta, GA and New York City (NYC). The NYC study was completed two years prior to the Atlanta study and found mental and physical benefits for the subgroups that responded best to the economic incentives provided. In this article, we present the findings from the Atlanta study, in which the uptake of the treatment (tax filings and EITC bonus) were lower and economic and health benefits were not observed., Methods: Paycheck Plus Atlanta was an unblinded randomized controlled trial that assigned n = 3,971 participants to either the standard federal EITC (control group) or an EITC supplement of up to $2,000 (treatment group) for three tax years (2017-2019). Administrative data on employment and earnings were obtained from the Georgia Department of Labor and survey data were used to examine validated measures of health and well-being., Findings: In Atlanta, the treatment group had significantly higher earnings in the first project year but did not have significantly higher cumulative earnings than the control group overall (mean difference = $1,812, 95% CI = -150, 3,774, p = 0.07). The treatment group also had significantly lower scores on two measures of mental health after the intervention was complete: the Patient Health Questionnaire 8 (mean difference = 0.19, 95% CI = 0.06, 0.32, p = 0.005) and the Kessler 6 (mean difference = 0.15, 95% CI = 0.03, 0.27, p = 0.012). Secondary analyses suggested these results were driven by disadvantaged men, but the study sample was in good mental health., Conclusions: The EITC experiment in Atlanta was not associated with gains in earnings or improvements in physical or mental health., (© 2023 The Authors. The Milbank Quarterly published by Wiley Periodicals LLC on behalf of The Milbank Memorial Fund.)

This study assesses distress and anxiety symptoms associated with quarantine due to COVID-19 exposure among the first quarantined community in the United States and identifies potential areas of intervention. All participants were directly or peripherally related to "patient 1,"-the first confirmed community-acquired case of COVID-19 in the New York Area. As such, this is a historically significant sample whose experiences highlight a transitional moment from a pre-pandemic to a pandemic period in the United States. In March 2020, an anonymous survey was distributed to 1,250 members of a NYC area community that was under community-wide quarantine orders due to the COVID-19 outbreak. Distress was measured using the Subjective Units of Distress Scale (SUDS) and symptoms of anxiety were measured using the Beck Anxiety Inventory (BAI). A variety of psychosocial predictors relevant to the current crisis were explored. Three hundred and three individuals responded within forty-eight hours of survey distribution. Mean levels of distress in the sample were heightened and sustained, with 69% reporting moderate to severe distress on the SUDS and 53% of the sample reported mild, moderate, or severe anxiety symptoms on the BAI. The greatest percentage of variance of distress and anxiety symptoms was accounted for by modifiable factors amenable to behavioral and psychological interventions., (© Copyright 2021 Springer Publishing Company, LLC.)

This study examines the effect and efficacy of visual designs for messages about poor air quality. The study utilized a 2 (message efficacy: high vs. low) × 2 (message design: visual vs. text) between-subjects experimental design, of N = 95 students from a large Western university. This experiment assessed the effects of message design and efficacy of language on students' visual comprehension, source credibility, self-efficacy, and protective behavioral intention. Hypotheses 1 and 2 were partially supported, finding that there were some statistically significant effects for efficacy and message design on students' comprehension and protective behavioral intention. Future work should focus on strategies for more salient air quality health communication because wildfires will continue to impact the western United States.

The current study examined anxiety and distress among members of the first community to be quarantined in the USA due to the COVID-19 pandemic. In addition to being historically significant, the current sample was unusual in that those quarantined were all members of a Modern Orthodox Jewish community and were connected via religious institutions at which exposure may have occurred. We sought to explore the community and religious factors unique to this sample, as they relate to the psychological and public health impact of quarantine. Community organizations were trusted more than any other source of COVID-19-related information, including federal, state and other government agencies, including the CDC, WHO and media news sources. This was supported qualitatively with open-ended responses in which participants described the range of supports organized by community organizations. These included tangible needs (i.e., food delivery), social support, virtual religious services, and dissemination of COVID-19-related information. The overall levels of distress and anxiety were elevated and directly associated with what was reported to be largely inadequate and inconsistent health-related information received from local departments of health. In addition, the majority of participants felt that perception of or concern about future stigma related to a COVID-19 diagnosis or association of COVID-19 with the Jewish community was high and also significantly predicted distress and anxiety. The current study demonstrates the ways in which religious institutions can play a vital role in promoting the well-being of their constituents. During this unprecedented pandemic, public health authorities have an opportunity to form partnerships with religious institutions in the common interests of promoting health, relaying accurate information and supporting the psychosocial needs of community members, as well as protecting communities against stigma and discrimination.

Objectives: We evaluated the economic benefits of Temporary Assistance to Needy Families (TANF) relative to the previous program, Aid to Families with Dependent Children (AFDC)., Methods: We used pooled mortality hazard ratios from 2 randomized controlled trials-Connecticut Jobs First and the Florida Transition Program, which had follow-up from the early and mid-1990s through December 2011-and previous estimates of health and economic benefits of TANF and AFDC. We entered them into a Markov model to evaluate TANF's economic benefits relative to AFDC and weigh them against the potential health threats of TANF., Results: Over the working life of the average cash assistance recipient, AFDC would cost approximately $28000 more than TANF from the societal perspective. However, it would also bring 0.44 additional years of life. The incremental cost effectiveness of AFDC would be approximately $64000 per life-year saved relative to TANF., Conclusions: AFDC may provide more value as a health investment than TANF. Additional attention given to the neediest US families denied cash assistance could improve the value of TANF.

Objectives: We examined whether Jobs First, a multicenter randomized trial of a welfare reform program conducted in Connecticut, demonstrated increases in employment, income, and health insurance relative to traditional welfare (Aid to Families with Dependent Children). We also investigated if higher earnings and employment improved mortality of the participants., Methods: We revisited the Jobs First randomized trial, successfully linking 4612 participant identifiers to 15 years of prospective mortality follow-up data through 2010, producing 240 deaths. The analysis was powered to detect a 20% change in mortality hazards., Results: Significant employment and income benefits were realized among Jobs First recipients relative to traditional welfare recipients, particularly for the most disadvantaged groups. However, although none of these reached statistical significance, all participants in Jobs First (overall, across centers, and all subgroups) experienced higher mortality hazards than traditional welfare recipients., Conclusions: Increases in income and employment produced by Jobs First relative to traditional welfare improved socioeconomic status but did not improve survival.

During the 1990s reforms to the US welfare system introduced new time limits on people's eligibility to receive public assistance. These limits were developed to encourage welfare recipients to seek employment. Little is known about how such social policy programs may have affected participants' health. We explored whether the Florida Family Transition Program randomized trial, a welfare reform experiment, led to long-term changes in mortality among participants. The Florida program included a 24-36-month time limit for welfare participation, intensive job training, and placement assistance. We linked 3,224 participants from the experiment to 17-18 years of prospective mortality follow-up data and found that participants in the program experienced a 16 percent higher mortality rate than recipients of traditional welfare. If our results are generalizable to national welfare reform efforts, they raise questions about whether the cost savings associated with welfare reform justify the additional loss of life.

We set out to examine the material, psychological, and sociological pathways mediating the income gradient in health and mortality. We used the 2008 General Social Survey-National Death Index dataset (N = 26,870), which contains three decades of social survey data in the US linked to thirty years of mortality follow-up. We grouped a large number of variables into 3 domains: material, psychological, and sociological using factor analysis. We then employed discrete-time hazard models to examine the extent to which these three domains mediated the income-mortality association among men and women. Overall, the gradient was weaker for females than for males. While psychological and material factors explained mortality hazards among females, hazards among males were explained only by social capital. Poor health significantly predicted both income and mortality, particularly among females, suggesting a strong role for reverse causation. We also find that many traditional associations between income and mortality are absent in this dataset, such as perceived social status.

Objective: Violence and homicide are more prevalent in Colombia, South America, than in the United States, but the role of psychosocial factors in the violent behavior of Colombian adolescents remains unclear. The objective of the study was to identify personality, familial, peer, and ecological variables associated with violence in Colombian adolescents., Method: A survey of adolescents was conducted in 1995-1996. A standard self-report measure was adapted to ensure linguistic and cultural relevance. A total of 2,837 adolescents ages 12-17 years from various self-reported ethnic groups were randomly selected from the community in three Colombian cities: Bogota, Medellin, and Barranquilla. Eighty percent of eligible adolescents agreed to participate. Data were collected concerning the adolescent's personality attributes, family characteristics, peer characteristics, and ecological/cultural factors, including the availability of illicit drugs and the prevalence of violence in the community. The dependent variable was the adolescent's self-reported frequency of violent behavior., Results: Violence directed at the adolescent and the adolescent's own drug use were both more highly correlated with the adolescent's violent behavior than were other risk factors. Significant risk factors of less importance included tolerance of deviance, peer drug use, peer deviance, and exposure to violence on television., Conclusions: The results supported a model in which violent behavior was correlated independently with a number of risk factors from several domains. The findings point to the use of specific intervention procedures for adolescents to prevent their own subsequent acts of violent behavior.