November 2005

Grant Results

National Program

Substance Abuse Policy Research Program

SUMMARY

Researchers from the University of Michigan, Pennsylvania State University and the University of Chicago analyzed the relationships among substance abuse, mental health problems, welfare and employment.

The project was part of the Robert Wood Johnson Foundation's (RWJF) national Substance Abuse Policy Research Program (SAPRP) (for more information see Grant Results).

Key Findings

  • 19 percent of female welfare recipients had used an illicit drug during the prior year.
  • 19 percent met the diagnostic screening criteria for major mental health problems.
  • Psychiatric disorders were more prevalent than drug dependence among recipients.

Key Recommendations

  • Screening and assessment programs should distinguish drug use from drug dependence and should identify alcohol dependence and psychiatric disorders.
  • States should provide a range of treatment services to address substance abuse and mental health problems among welfare recipients.

Funding
RWJF provided a grant of $341,087 from July 1998 through December 2001.

 See Grant Detail & Contact Information
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THE PROBLEM

In 1996, Congress enacted welfare reform legislation that ended the federal entitlement to welfare benefits, established lifetime limits on benefits for recipients and emphasized helping welfare recipients find work.

Welfare administrators and policy-makers have been concerned that recipients with serious barriers to work, such as substance abuse or mental health problems, would be wrongly dropped from the welfare roles. These officials were interested in learning about the prevalence of substance abuse and mental health problems among welfare recipients after welfare reform and the extent to which these problems affected recipients' ability to find and maintain work.

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THE PROJECT

With support under RWJF's Substance Abuse Policy Research Program, Sheldon H. Danziger, Ph.D., and a team of researchers at the University of Michigan, in collaboration with researchers from Pennsylvania State University and the University of Chicago, analyzed data from the 1994 and 1995 National Household Survey of Drug Abuse, an annual national survey of people who are more than 11 years old.

Data from the 1994 and 1995 National Household Survey of Drug Abuse predates passage of welfare reform legislation, thus providing a baseline for analyzing the effect of subsequent changes in welfare policy on substance use and mental health problems. Researchers addressed three types of questions:

  1. What proportion of welfare recipients has substance abuse and mental health problems?
  2. What are the relationships among substance abuse, mental health problems, work and welfare?
  3. Do work and welfare experiences affect substance abuse and mental health?

Investigators analyzed data based on survey responses from 2,728 single mothers, both welfare recipients and nonrecipients, who were at least 18 years old and who lived with at least one minor child. About 32 percent of women who responded to the survey were on welfare during the two years of the study.

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FINDINGS

The investigators reported the following findings in several journal articles, including the Journal of Health Politics, Policy and Law:

  • Illicit drug use and dependence are more common among women who receive welfare than among women who do not receive benefits, and drug use is a risk factor for welfare receipt even after taking into account factors such as race, educational attainment or geographic region.
    • Of welfare recipients surveyed, 21 percent said they had used an illicit drug during the prior year, compared with 13 percent of nonrecipients.
    • 9 percent of recipients met the criteria for alcohol dependence, compared with 5 percent of nonrecipients.
    • 5 percent of recipients said they had used cocaine in the prior year and 3 percent said they had used crack, compared with 3 percent of nonrecipients who said they used cocaine and 0.8 percent who said they had used crack.
  • Of recipients surveyed, 19 percent met the diagnostic screening criteria for major depression, generalized anxiety disorders, agoraphobia or panic attacks during the prior year, compared with 13 percent of nonrecipients.
  • Psychiatric disorders, especially major depression and post-traumatic stress disorder, are more prevalent than illicit drug dependence among welfare recipients.
  • Of recipients surveyed, 58 percent said they smoked cigarettes compared with 45 percent of nonrecipients.
  • Although illicit drug users are rarely dependent on drugs, many face barriers to self-sufficiency.

Limitations

Researchers noted the following study limitation:

  • Information from these data sources is based on self-reports of people surveyed. To the extent that people do not report sensitive issues such as substance use or mental health problems, the extent of these problems might be understated.

Recommendations

Researchers offered the following recommendations based on this study:

  • Screening and assessment programs should distinguish drug use from drug dependence and should identify alcohol dependence and psychiatric disorders.
  • States should provide a range of treatment services to address substance abuse and mental health problems among welfare recipients.

Communications

Project staff published articles in the Journal of Health Politics, Policy and Law and Women's Health Issues. Principal investigator Danziger wrote a chapter featured in a book that the Brookings Institution published. See the Bibliography for details. A project summary and journal abstracts are available online.

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AFTER THE GRANT

Researchers added a new source of data, the National Health Interview Survey, to future research and they added additional waves of data from the Michigan Women's Employment Study. The Joyce Foundation and the Charles Stewart Mott Foundation provided additional funds to allow researchers to analyze these subsequent waves of data from the Women's Employment Study.

In April 2003, the Substance Abuse and Policy Research Program awarded the principal investigator a $289,092 grant for Analyzing the Prevalence and Effects of Substance Abuse Among Current and Former Welfare Recipients (ID# 047841).

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GRANT DETAILS & CONTACT INFORMATION

Project

Substance Abuse and Welfare Reform

Grantee

University of Michigan (Ann Arbor,  MI)

  • Amount: $ 341,087
    Dates: July 1998 to December 2001
    ID#:  034904

Contact

Sheldon H. Danziger, Ph.D.
(734) 615-8321
sheldond@umich.edu

Web Site

http://www.saprp.org
http://www.saprp.org/grant_publications.cfm?appId=783

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BIBLIOGRAPHY

(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)

Book Chapters

Danziger S. "Comment on TANF and the Most Disadvantaged Families' Well-Being." In The New World of Welfare, Blank RM and Haskins R (eds.). Washington: Brookings Institution, 2001.

Articles

Jayakody R, Danziger S and Pollack H. "Welfare Reform, Substance Use, and Mental Health." Journal of Health Politics, Policy and Law, 25(4): 623–651, 2000. Abstract available online.

Levine JA, Pollack H and Comfort ME. "Academic and Behavioral Outcomes Among Children of Young Mothers." Journal of Marriage and the Family, 63(2): 355–369, 2001.

Pollack H, Danziger S, Jayakody R and Seefeldt K. "Drug Testing Welfare Recipients — False Positives, False Negatives, Unanticipated Opportunities." Women's Health Issues, 12(1): 23–31, 2002. Abstract available online.

Pollack HA, Danziger S, Seefeldt KS and Jayakody R. "Substance Use among Welfare Recipients: Trends and Policy Responses." Social Service Review, 76(2): 256–274, 2002.

Reports

Mainieri T and Danziger S. Designing Surveys of Welfare Populations. University of Michigan, Center on Poverty, Risk and Mental Health, 2002. Available online.

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Report prepared by: Barbara Matacera Barr
Reviewed by: Mary Nakashian
Reviewed by: Molly McKaughan
Program Officer: Victor A. Capoccia
Program Officer: C. Tracy Orleans

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