Elizabeth T. Wilde, Zohn Rosen, and Peter A. Muennig, are with the Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY. Kenneth Couch is with the Department of Economics, University of Connecticut, Storrs.
Am J Public Health. 2014 Mar;104(3):534-8. doi: 10.2105/AJPH.2012.301072. Epub 2013 May 16.
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.
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.
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.
Increases in income and employment produced by Jobs First relative to traditional welfare improved socioeconomic status but did not improve survival.
我们考察了康涅狄格州实施的一项福利改革计划——“先工作”（Jobs First）多中心随机试验，该计划是否在就业、收入和医疗保险方面相对于传统福利（救助有受抚养子女的家庭，Aid to Families with Dependent Children）有所增加。我们还研究了较高的收入和就业率是否改善了参与者的死亡率。
我们重新分析了“先工作”随机试验，通过 2010 年的前瞻性死亡率随访数据成功地将 4612 名参与者的标识符与 15 年的数据联系起来，产生了 240 例死亡。该分析有能力检测到死亡率风险的 20%变化。
“先工作”的参与者相对于传统福利的参与者实现了显著的就业和收入效益，尤其是对于最弱势群体。然而，尽管这些都没有达到统计学意义，但“先工作”的所有参与者（总体上、在各个中心和所有亚组中）的死亡率风险都高于传统福利的参与者。
“先工作”相对于传统福利所带来的收入和就业的增加改善了社会经济地位，但并没有改善生存。
