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Financial well-being and overall health are significantly linked, especially among those in poverty who have been exposed to violence and suffer from unaddressed trauma. Yet existing public assistance programs fail to address the presence or impact of trauma and adversity. Built specifically for families living in poverty who experience adversity, the Building Wealth and Health Network (the Network) provides a space for families to heal from the effects of trauma while also building social networks and economic security. The sample for this study was primarily Black (91%) women (92%) in Philadelphia with at least one child. A repeated measures linear regression model was performed via a Difference-in-Differences approach to test differences in financial well-being scores between two groups (full participation vs. low/no participation) at two time points (baseline vs 3 months, and baseline vs 6 months). We use this program as a field study to better understand the financial well-being of program participants who took part in fewer or more program sessions. Those who participated in more sessions reported greater increases in two measures of financial well-being at three months and six months post baseline, when compared to those with low or no participation. Highlights: Financial health and overall well-being are linked. Participation in trauma-informed, healing-centered financial empowerment programming is associated with improved financial well-being. This provides evidence for a new alternative model of public assistance programming. [ABSTRACT FROM AUTHOR]

Administrative decisions mediate whether the millions who turn to the state for social services annually can access the assistance they need. We introduce the concept of intersectional burdens—which describes how a person’s social location (including race, class, gender, age, and ability) shapes their access and use of state benefits and programs—to account for the ways mutually reinforcing systems structure experiences with the state and to better understand how inequalities are experienced, reproduced, and resisted. We illustrate the intersectional nature of associated costs by drawing on a random stratified sample of sixty-one Black, Latinx, and White women’s experiences from the American Voices Project. We find that individuals who seek public safety net assistance do not experience administrative burdens in the same way or to the same degree and that social location substantively affects how people navigate administrative burdens in public income assistance processes, health-care systems, and housing experiences.

In the decades following the Mexican Revolution, many sick people traveled to Mexico City, where most hospitals had traditionally been located, in search of medical care. This article argues that these healing journeys were a crucial component of how the Mexican welfare state functioned in practice between the late 1930s and the early 1960s. During this period, the postrevolutionary government ostensibly sought to expand the population's access to health care. However, despite some efforts in this direction, limited investment in public health and social services jeopardized citizens' access to adequate medical and hospital care. At the end of this period, most of the country's public hospitals were still concentrated in the capital, while the medical infrastructure in some provinces was virtually nonexistent. In this context, healing journeys became one of the ways in which citizens sought to realize the promised right to health care. [ABSTRACT FROM AUTHOR]

Administrative decisions mediate whether the millions who turn to the state for social services annually can access the assistance they need. We introduce the concept of intersectional burdens--which describes how a person's social location (including race, class, gender, age, and ability) shapes their access and use of state benefits and programs--to account for the ways mutually reinforcing systems structure experiences with the state and to better understand how inequalities are experienced, reproduced, and resisted. We illustrate the intersectional nature of associated costs by drawing on a random stratified sample of sixty-one Black, Latinx, and White women's experiences from the American Voices Project. We find that individuals who seek public safety net assistance do not experience administrative burdens in the same way or to the same degree and that social location substantively affects how people navigate administrative burdens in public income assistance processes, health-care systems, and housing experiences. [ABSTRACT FROM AUTHOR]

In this study, we analyze the changes in the composition of Ukrainian households participating in mass migration to Krakow, Poland, at the onset of the war and verify the significance of their newly formed composition for their financial situation abroad. For this purpose, we utilize household-level data and statistical inference methods. The findings reveal that the decisions to leave the home country were often associated with separation, not only from life partners but also from elderly members of the households. We confirm the significance of the presence of specific household members, such as life partners, other adults, and children, for households opportunities and limitations in the host country. We recognize households with seniors as having the most challenging financial situation. Conversely, singles and households with adults other than life partners are found to have the highest degree of self-reliance due to their access to private financial resources and social networks. Migrating couples tended to rely on public assistance but were determined to find employment. Households with children were found to be dependent on diverse forms of public assistance and showed less interest in gainful employment but open to social integration. [ABSTRACT FROM AUTHOR]

Background: Relieving the total pain of patients with cancer and supporting their well-being throughout their lives are important roles of palliative and supportive care. Poverty may inhibit patients from receiving dignified end-of-life care; however, using social welfare services may reduce its impact on patients? end-of-life experiences. Nevertheless, no study has investigated which social welfare service could lead to favorable end-of-life experiences for patients living in poverty. Objective: This study aimed to describe the characteristics of users of palliative care among low-income patients and examine the difference in survival time among patients with cancer on social welfare services in a single center in Kyoto, Japan. Design: We conducted a retrospective cohort study. Setting/Subjects: We included 220 patients using Public Assistance (PA: aid minimum income and medical/long-term care), Free/Low-Cost Medical Care (FLCMC: aid only medical care), and nonwelfare-users who newly received palliative care in 2021. Measurements: We calculated patients? survival time from the initiation of palliative care to death. In addition, we identified patients who experienced home death. Results: Compared with nonusers, FLCMC beneficiaries had shorter survival times (adjusted hazard ratio [aHR] 2.05, 95% confidence interval [CI] 0.80?5.22). No difference was observed among PA beneficiaries (aHR 1.19, 95% CI 0.49?2.87). No home death was observed among welfare service recipients. Conclusions: Social welfare benefits only for medical expenses may not sufficiently support dignified end-of-life care for low-income patients. Further studies are required to examine the robustness of this study considering various bio-psycho-social factors that can influence these findings, to support low-income patients with cancer on social welfare services.

Objective: This study examines the association between public assistance use and depressive symptoms among young adults experiencing homelessness (YAEH). Method: A purposive sample of 1,342 YAEH (ages 18–26) residing in seven U.S. cities (Denver, CO; Houston, TX; Los Angeles and San Jose, CA; New York, NY; Phoenix, AZ; and St. Louis, MO) were asked whether they received any form of public assistance over the past year, of which 45% did. The Patient Health Questionnaire-9 was used to assess depressive symptoms. We used propensity score matching to balance the two groups (i.e., public assistance recipients and nonrecipients) and account for selection bias, then we conducted multivariate ordinary least squares regression analysis to examine the relationship between public assistance and depressive symptoms. Results: YAEH who had used public assistance had a significantly higher depression score (b = 1.13 , p =.004) than nonrecipients. Conclusions: Findings suggest many possible connections between public assistance use and depression, yet public assistance does not appear to improve mental health for a population facing multiple challenges and barriers. Further research is needed to understand the directional relationship between public assistance and mental health for this population. Social workers should be especially attentive to the mental well-being of young, homeless public assistance recipients. [ABSTRACT FROM AUTHOR]

Poverty, a social determinant of health, disproportionately affects families with children. Public and private safety nets, or support networks available in times of need, can help address poverty and its consequences. Independently, strong safety nets (public or private) promote health and well-being, yet little is known about how private and public safety nets combine and evolve over time. Using latent class and latent transition analyses, this study examined public and private safety net configurations of mothers with low-income, sociodemographic characteristics associated with these configurations, and safety net changes over time. Using data from the Future of Families and Child Wellbeing Study from child ages 1, 5, and 9 (N = 2,251), results indicated that mothers were sorted into four safety net configurations (public support only, private support only, all high, and all low) and 30%–53% of each class of mothers transitioned from one safety net configuration to another at the next neighboring wave, underscoring the importance of examining both public and private supports simultaneously and longitudinally. Membership in configurations with low private support (e.g., public only, all low) and sociodemographic disadvantage (e.g., more poverty, recent experience of hardship) predicted transitions, commonly leaving mothers without advantage in the riskiest safety nets. To promote a more responsive, equitable safety net, lengthening public safety net program certification periods and increasing outreach efforts (e.g., through schools, churches) to potentially eligible mothers could strengthen and stabilize safety nets to lessen poverty and its consequences for economically marginalized families. Public Policy Relevance Statement: The potential benefits of public and private safety nets, or support networks available in times of need, are clear. Study findings suggested four safety net configurations, and mothers, particularly those facing high disadvantage, were susceptible to risky safety nets and instability. Broadening program outreach and lessening the burden of program receipt could be valuable approaches in decreasing poverty and its consequences for economically marginalized families. [ABSTRACT FROM AUTHOR]

The concept of poverty is a multidimensional term that varies from person to person and from country to country. Therefore, there is no consensus on the definition of poverty. The phenomenon of poverty, which can be defined as the state of lacking the economic capacity to meet basic needs and experiencing deprivation at a minimum standard of living, has existed throughout human history. Since the 1990s, research has been conducted on this issue, and it has been recognized as a global problem with the poverty report published by the World Bank in 1990. With its recognition as a global problem, countries have started to develop various policies to combat poverty. In this regard, the Social Assistance and Solidarity Promotion Law (SYDTK) No. 3294, which came into effect on June 14, 1986, and the Social Aid and Solidarity Promotion Fund (SYDTF) were established as the first institutional structure in Türkiye to combat poverty. Social Aid and Solidarity Foundations were established in each province and district to achieve the objectives of the established Fund. The first part of this study examines the phenomenon and types of poverty, as well as the concept of social assistance. The second part focuses on women's poverty, its causes, and social policy issues. The third part provides general information about the structure of Social Aid and Solidarity Foundations, which are mechanisms for combating poverty. The final part, which includes field research, provides information about the services provided by the Düzce Social Aid and Solidarity Foundation, and examines the findings obtained from a survey conducted with 385 women who received social assistance from the Foundation. This study aims to examine the demographic characteristics of women receiving social assistance, their socioeconomic status, the types of assistance they benefit from, and assess the effects and visibility of the aid from the perspective of women. Additionally, a situational evaluation is conducted to determine whether these aids are effective in preventing female poverty. The perception of women regarding the effectiveness of the social assistance provided by the Social Aid and Solidarity Foundations (SYDFs) is also measured. [ABSTRACT FROM AUTHOR]

Objectives: Exemption from paying dental care costs among recipients of public assistance contributes to universal health care coverage. Although this system might reduce the financial barriers to dental care among patients, there are still several other barriers for public assistance recipients. Therefore, this study examined whether receiving public assistance was associated with a higher prevalence of dental visits for any reason, treatment and prevention. Methods: Data were obtained from 16 366 respondents from the 2019 wave of a nationwide cohort study on older adults in Japan. Poisson regression analyses with robust error variance were used to examine the associations between receiving public assistance and dental visits, adjusting for number of teeth, dental pain, periodontal conditions, age, sex, number of family members, education, equivalent household income, working status, instrumental activities of daily living, medical conditions, depressive symptoms, instrumental support and geographical variations. Results: More than half of the non‐recipients of public assistance visited a dentist for some reason in the past 6 months. Meanwhile, only 37% of the recipients visited a dentist. In addition, almost half of the non‐recipients had treatment visits, while only 34% of the recipients visited. Furthermore, 46% of the non‐recipients had dental visits for prevention, while 32% of the recipients had preventive visits. In the fully adjusted models, compared to non‐recipients, public assistance recipients were 24% (Prevalence Ratio [PR]: 0.76, 95% Confidence Intervals [CI]: 0.64, 0.90), 23% (PR: 0.77, 95% CI: 0.65, 0.92) and 21% (PR: 0.79, 95% CI: 0.65, 0.95) less likely to have dental visits for any reason, treatment, and prevention, respectively. Conclusions: Although recipients were exempted from dental treatment fees, receiving public assistance was associated with a lower prevalence of dental visits for any reason, treatment and prevention. Future studies should identify the barriers to accessing dental care among public assistance recipients to improve dental visits. [ABSTRACT FROM AUTHOR]

Abstract Background Public assistance programs aim to prevent financial poverty by guaranteeing a minimum income for basic needs, including medical care. However, time poverty also matters, especially in the medical care adherence of people with chronic diseases. This study aimed to examine the association between the dual burden of working and household responsibilities, with unscheduled asthma care visits among public assistance recipients in Japan. Methods This retrospective cohort study included public assistance recipients from two municipalities. We obtained participants’ sociodemographic data in January 2016 from the public assistance database and identified the incidence of asthma care visits. Participants’ unscheduled asthma visits and the frequency of asthma visits were used as the outcome variables. Unscheduled visits were defined as visits by recipients who did not receive asthma care during the first three months of the observation period. Participants’ age, sex, household composition, and work status were used as explanatory variables. Multiple Poisson regression analyses were performed to calculate the cumulative incidence ratio (IR) with a 95% confidence interval (CI) of unscheduled visits across the explanatory variables. The effect of modification on the work status by household composition was also examined. Results We identified 2,386 recipients at risk of having unscheduled visits, among which 121 patients (5.1%) had unscheduled visits. The multivariable Poisson regression revealed that the working recipients had a higher incidence of unscheduled visits than the non-working recipients (IR 1.44, 95% CI 1.00–2.07). Among working recipients, the IRs of unscheduled visits were higher among recipients cohabiting with adults (IR 1.90 95% CI 1.00–3.59) and with children (IR 2.35, 95% CI 1.11–4.95) than for recipients living alone. Among non-working recipients, the IRs of unscheduled visits were lower for recipients living with family (IR 0.74, 95% CI 0.41–1.35) and those living with children (IR 0.50, 95% CI 0.20–1.23). A higher frequency in asthma visits was observed among working recipients living with family. Conclusions Working adults cohabiting with children are at the greatest risk of unscheduled visits among adults receiving public assistance. To support healthy lifestyles of public assistance recipients, medical care providers and policymakers should pay special attention to the potentially underserved populations.

Household energy consumption is crucial for a productive and safe life. Despite its importance, 33.7 million U.S. households experienced energy insecurity in 2020. This paper examines the prevalence, correlates, and effects of energy bill assistance programs, which aim to alleviate the hardship. This analysis relies on logistic regressions and the 2020 Residential Energy Consumption Survey, a nationally representative survey administered by the Energy Information Administration. Results reveal 16 percent of the energy insecure population received assistance to pay its energy bill in 2020. Several socioeconomic and housing characteristics are associated with receipt of assistance; however, logistic regression estimates suggest prior participation in energy assistance and receipt of a disconnection notice from a utility provider are indicators substantively and significantly associated with energy assistance participation that warrant attention from scholars and practitioners. Lastly, outcomes generally indicate previous participation in energy assistance does not impact the odds a household will experience energy insecurity. Based on findings, I offer three policy recommendations: 1) increase resources spent on energy assistance to align with demand; 2) enhance communication between utility providers and low-income households regarding available assistance opportunities; and 3) prioritize engagement with populations that never participated in energy assistance to facilitate successful application processes.

As the obligatory provider standard was phased out in livelihood and housing benefits except medical benefits in 2017, this study examined how the gender gap of take-up rate changed over time. First, the female poverty rate decreased, but the gender poverty gap did not change. Second, the take-up rate of males who receive housing benefit was the highest, while the take-up rate of females who receive medical benefit was the lowest. Lastly, the number of the non-take-up fell for men, while, for women, it only began to decrease in 2021 when the obligatory provider standard was abandoned. [ABSTRACT FROM AUTHOR]

The negative impacts of the Great Recession (GR) (2007 to 2009) on the lives of families with low incomes warrant social work concerns about how well antipoverty policy responded to meet economic needs over this period and since. Given America's long-standing tension between welfare state adequacy and market-oriented policies, how well did the safety net respond to the economic downturn? Did GR-era changes reverse or accelerate trends in public assistance? This article examines key policy changes and indicators of caseloads, inclusion, and generosity for three antipoverty policies: the Temporary Assistance for Needy Families, the Supplemental Nutrition Assistance Program (SNAP, formerly Food Stamp Program), and the Earned Income Tax Credit from 2007 to 2017. Authors' analysis shows a continuation of market-oriented U.S. antipoverty policy. Authors argue that the reemphasis of conditioning benefits on employment undermines the countercyclical feature of the social safety net and perpetuates the inequitable redistribution of public resources between those inside and outside of the labor market. Authors discuss social workers' role in strengthening antipoverty policies to improve the economic well-being of people with low incomes and the economic justice of the social safety net.

Background: Although assistance programs (i.e. Medicaid, SNAP, and food pantries) are proven to ensure access to necessary resources and improve health outcomes, evidence shows that participants experience stigma due to their participation in these programs, creating barriers to participation and further marginalization of low-income families. In the U.S., welfare stigma is rooted in values of personal responsibility that perpetuate harmful stereotypes about assistance users. Internalized, interpersonal, and structural stigma are manifestations of stigma that may be experienced by assistance users. Methods: One-on-one, semi-structured interviews were conducted with a geographically stratified sample of adult Medicaid participants in Missouri (n = 72). Interviews were transcribed verbatim and analyzed using inductive and deductive coding. Thematic content analysis was employed to derive and report the main themes. Results: Among our sample, internalized, interpersonal, and structural stigma were experienced through the value of personal responsibility, program design and implementation, and program utilization. Through the value of personal responsibility, participants shared feelings of shame related to using public assistance (internalized stigma) and exceptionalism when comparing themselves to other users of public assistance (interpersonal stigma). Within program implementation, participants reported the prejudice they experienced through interactions with programmatic staff (interpersonal stigma) and described experiencing administrative barriers to accessing programs (structural stigma). Lastly, participants discussed how stigma influenced their utilization of public assistance programs, including decisions to enroll and engage in programs. Conclusion: Our study adds to existing understanding about how assistance users experience stigma and how internalized, interpersonal, and structural stigma impact assistance program uptake and utilization.

Background: Public assistance programs aim to prevent financial poverty by guaranteeing a minimum income for basic needs, including medical care. However, time poverty also matters, especially in the medical care adherence of people with chronic diseases. This study aimed to examine the association between the dual burden of working and household responsibilities, with unscheduled asthma care visits among public assistance recipients in Japan. Methods: This retrospective cohort study included public assistance recipients from two municipalities. We obtained participants' sociodemographic data in January 2016 from the public assistance database and identified the incidence of asthma care visits. Participants' unscheduled asthma visits and the frequency of asthma visits were used as the outcome variables. Unscheduled visits were defined as visits by recipients who did not receive asthma care during the first three months of the observation period. Participants' age, sex, household composition, and work status were used as explanatory variables. Multiple Poisson regression analyses were performed to calculate the cumulative incidence ratio (IR) with a 95% confidence interval (CI) of unscheduled visits across the explanatory variables. The effect of modification on the work status by household composition was also examined. Results: We identified 2,386 recipients at risk of having unscheduled visits, among which 121 patients (5.1%) had unscheduled visits. The multivariable Poisson regression revealed that the working recipients had a higher incidence of unscheduled visits than the non-working recipients (IR 1.44, 95% CI 1.00–2.07). Among working recipients, the IRs of unscheduled visits were higher among recipients cohabiting with adults (IR 1.90 95% CI 1.00–3.59) and with children (IR 2.35, 95% CI 1.11–4.95) than for recipients living alone. Among non-working recipients, the IRs of unscheduled visits were lower for recipients living with family (IR 0.74, 95% CI 0.41–1.35) and those living with children (IR 0.50, 95% CI 0.20–1.23). A higher frequency in asthma visits was observed among working recipients living with family. Conclusions: Working adults cohabiting with children are at the greatest risk of unscheduled visits among adults receiving public assistance. To support healthy lifestyles of public assistance recipients, medical care providers and policymakers should pay special attention to the potentially underserved populations. [ABSTRACT FROM AUTHOR]

How does the receipt of public assistance and social insurance relate to charitable giving and volunteering? Using data from the 2017 wave of Panel Study of Income Dynamics in the US, we employ a series of multilevel logistic regressions and tobit models to answer the research question. Results show that the receipt of public assistance and social insurance is not significantly related to volunteering. The receipt of social insurance is also not significantly associated with charitable giving, but the receipt of public assistance has a small, negative relationship with the recipients' charitable giving. Moreover, how public assistance associates with charitable giving and volunteering varies with different public assistance programs, whereas the relationship between social insurance and charitable giving and volunteering remains insignificant when different social insurance programs are analyzed. [ABSTRACT FROM AUTHOR]

Whether national and local governments should assume larger financial responsibility for reducing disaster risk remains a controversial issue. Local governments lack resources to cover the full cost of managing mega-disasters and need assistance from higher level governments. However, national governments covering all costs may create moral hazards, discouraging local governments from investing in ex-ante measures. This study identifies national and local governments' fiscal responsibility determinants for disaster management. Despite the differences between the federal system in the US and the centralized system in Japan, the two countries' national governments share common practices. Both have continuously developed legislation to expand their financial responsibilities for relief and recovery efforts as disaster consequences have increased. We argue that despite major institutional differences in Japan's unitary and the US federal government systems, both have expanded the areas covered by national assistance along with the amount over time. These findings bring with them recommendations for governments in an era of increasing extreme weather events due to climate change. [ABSTRACT FROM AUTHOR]

Financial stress is the root cause of many adverse health outcomes among poor and low-income children and their families, yet few clinical interventions have been developed to improve health by directly addressing patient and family finances. Medical-Financial Partnerships (MFPs) are novel cross-sector collaborations in which health care systems and financial service organizations work collaboratively to improve health by reducing patient financial stress, primarily in low-income communities. Financial services provided by MFPs include individually tailored financial coaching, free tax preparation, budgeting, debt reduction, savings support, and job assistance, among others. MFPs have been shown to improve finances and, in the few existing studies available, health outcomes. We describe the rationale for MFPs and examine 8 established MFPs providing financial services under 1 of 3 models: full-scope on-site service partnerships; targeted on-site service partnerships; and partnerships facilitating referral to off-site financial services. The services MFPs provide complement clinical social risk screening and navigation programs by preventing or repairing common financial problems that would otherwise lead to poverty-related social needs, such as food and housing insecurity. We identify common themes, as well as unique strengths and solutions to a variety of implementation challenges MFPs commonly encounter. Given that the financial circumstances and health outcomes of socially marginalized patients and families are closely linked, MFPs represent a promising and feasible cross-sector service delivery approach and a new model for upstream health care to promote synergistic financial well-being and health improvement.

Objectives Previous studies have reported that people with disabilities are more likely to be impoverished and affected by excessive medical costs than people without disabilities. Public transfer income (PTI) reduces financial strain in low-income households. This study examined the impact of PTI on catastrophic health expenditures (CHE), focusing on low-income households and households with Medical Aid beneficiaries that contained people with disabilities. Methods We constructed a panel dataset by extracting data on registered households with disabilities from the Korea Welfare Panel Study 2012-2019. We then used a generalized estimating equation model to estimate the impacts of PTI on CHE. A subgroup analysis was carried out to assess the moderating effects of family income levels and health insurance types. Results As PTI increased, the odds ratio (OR) of CHE in households that contained people with disabilities decreased significantly (OR, 0.92; 95% confidence interval [CI], 0.89 to 0.94; p

Objective. To assess the effect of coverage of the Bolsa Família Program (BFP) on oral cancer mortality rates in Brazil between 2005 and 2017, adjusting for health care coverage and socioeconomic characteristics of the Brazilian federative units. Methods. This is an ecological study using annual data (2005–2017) from all the Brazilian federative units. The dependent variable for this study was the oral cancer mortality rate, standardized by gender and age using the direct standardization technique. BFP coverage was the main independent variable, calculated as the ratio of the number of BFP beneficiaries to those families that should potentially be entitled to this conditional cash transfer. Socioeconomic background and health care coverage were covariables. Choropleth maps were drawn, and space-time cube analysis was used to assess changes in the spatiotemporal distribution of BFP and oral cancer mortality rates. Mixed-effects linear regression analysis estimated the coefficients (β) and 95% confidence intervals (CI) for the association between BFP coverage and oral cancer mortality rates. Results. BFP coverage trends increased and oral cancer mortality rate trends stabilized in Brazilian federative units, except for Maranhão, Goiás, and Minas Gerais, where the oral cancer mortality rates have increased. In the adjusted model, greater BFP coverage was associated with lower oral cancer mortality rates (β –2.10; 95% CI [–3.291, –0.919]). Conclusions. Egalitarian strategies such as BFP can reduce the oral cancer mortality rate. We recommend the follow-up of families benefiting from conditional cash transfer program by oral health teams to reduce the oral cancer mortality rate.

Abstract Background Low-income is one of the well-established determinants of people’s health and health-related behavior, including susceptibility to the coronavirus disease 2019 (COVID-19) infection. Two social welfare services are available in Japan to support financial and medical care among low-income patients: Public Assistance (PA), which provide both minimum income and medical costs; and Free/Low-Cost Medical Care (FLCMC), wherein only medical costs were covered. In this study, changes in Health-Related Quality of Life (HRQOL) scores of low-income patients on PA and FLCMC, before and after COVID-19 pandemic, were described and compared against those that are not utilizing the said services (comparison group) to evaluate the contribution of social welfare services in protecting the HRQOL of the beneficiaries during the pandemic. Methods We used repeated cross-sectional data of adult beneficiaries of FLCMC and PA, as well as those without social welfare services, who regularly visit the Kamigyo clinic in Kyoto, Japan. We collected the data from 2018 and 2021 using a questionnaire on patients’ socioeconomic attributes and the Japanese version of Medical Outcomes Study 12-Item Short Form Health Survey (SF-12). The Japanese version of SF-12 can calculate the three components scores: physical health component summary (PCS), the mental health component summary (MCS), and the role-social component summary (RCS), which can be transformed to a 0–100 range scale with a mean of 50 and standard deviation of 10. Results Data of 200 and 174 beneficiaries in 2018 and 2021, respectively, were analyzed. Low-income patients on social welfare services had lower PCS, and RCS than the comparison group in both years. Multiple linear regression analyses with cluster-adjusted standard error estimator showed that the decline in MCS was significantly higher among FLCMC beneficiaries than in those without welfare services (Beta: -4.71, 95% Confidence Interval [CI]: –5.79 to -3.63, p

Food is one of the physiological needs that have an immediate impact on healthy aging. However, the persistent poverty problem in Hong Kong has increasingly made it difficult for low-income older persons to meet their basic needs. This paper examines to what extent poor older persons suffer from food insecurity and how their food insecurity is related to the different types of resources they have. Based on the data collected through a questionnaire survey and in-depth interviews, the study found that about 20% of low-income older persons experienced food insecurity, and male, older seniors, and those in a larger household with lower socio-economic status were particularly vulnerable. Among the resources that older people can utilize, public assistance and social services were found to be more conducive to food security than social capital. The implementation of a food voucher scheme and the facilitation of food distribution and social eating are suggested. [ABSTRACT FROM AUTHOR]

ObjectiveEvaluate how coverage and quality of primary health care (PHC) and a conditional cash transfer (CCT) program associate with child mortality in Brazil.MethodsMultivariate linear regression models and least absolute shrinkage and selection estimator (LASSO) were utilized with the municipal level child mortality rate as the key dependent variable. PHC quality with PHC and CCT coverage were the independent variables. The quality of the Brazilian PHC was assessed using the Brazilian National Program for Access and Quality Improvement in PHC data. PHC and CCT coverage were calculated based on Brazilian official databases. Human developmental index (HDI), municipality size, and country region were used as control variables. A total of 3441 municipalities were evaluated.ResultsWe found that ESF (Estratégia Saúde da Família) quality variables PLANNING [Family Health Team Planning activities], CITYSUPPORT [municipality support for Family Health Strategy activities], EXAMS [exams offered and priority groups seen by the family health team], and PRENATAL [prenatal care and exams provided by the family health team], as well as HDI, percentage of PHC coverage, percentage of CCT coverage, and population size have significant and negative relationships with 1-year-old child mortality. LASSO regression results confirmed these associations. Quality is an important element of effective social service provision.ConclusionThis exploration represents one of the first investigations into the role of PHC system quality, and how it is related to health outcomes, while also considering PHC and conditional cash transfer program coverage. Quality of PHC, measured by work process variables, plays an important role in child mortality. Efforts on PHC quality and coverage, as well as on CCT program coverage, are important to child mortality reduction. Therefore, this is an important finding to other PHC public health services.

PurposeTo examine whether food insecurity longitudinally affects smoking status.DesignPopulation-based prospective study.SettingData from the 2003 and 2015 Panel Study of Income Dynamics (PSID).ParticipantsFour thousand five hundred sixty-three adults who were smokers and nonsmokers, participating in the 2003 (current study baseline) and 2015 (current study follow-up) waves of PSID.MeasuresBased on self-reported smoking status at baseline and follow-up, respondents were categorized as continued smoking, stopped smoking, started smoking, and continued nonsmoking. Similarly, respondents were categorized as stayed food secure, stayed food insecure, became food insecure, and became food secure based on responses to the Food Security Survey at baseline and follow-up.AnalysisTwo logistic regression analyses to examine (1) among smokers at baseline the odds of stopping versus continuing smoking by follow-up and (2) among nonsmokers at baseline the odds of starting versus continuing nonsmoking by follow-up. In both models, change in food insecurity status was the primary independent variable, controlling for demographics including poverty.ResultsAmong smokers at baseline, becoming food insecure (vs staying food secure) was independently associated with lower likelihood of stopping smoking by follow-up (odds ratio [OR] = 0.66). Among nonsmokers at baseline, becoming food insecure (vs staying food secure) was independently associated with higher likelihood of starting smoking by follow-up (OR = 3.77).ConclusionsFood insecurity is a risk factor for smoking, which has significant implications for developing interventions to reduce smoking prevalence, especially among low-income groups.