London School of Economics and Political Science UK.
University of Sydney, Australia and Institute for the Study of Labour (IZA), Germany.
J Health Econ. 2022 Jul;84:102618. doi: 10.1016/j.jhealeco.2022.102618. Epub 2022 Apr 7.
In 2007, Australia introduced its most radical welfare reform in recent history, targeting Aboriginal communities with the aim of protecting children from harm. The 'income management' policy forced Aboriginal welfare recipients to spend at least half of their government transfers on essentials (e.g. food, housing), and less on non-essentials (e.g. alcohol, tobacco). By exploiting its staggered rollout, we estimate the impact of in utero exposure to the policy rollout on birthweight. We find that exposure to the income management policy reduced average birthweight robustly by 85 g and increased the risk of low birth weight by 3 percentage points. This finding is not explained by behavioral change (fertility, maternal risk behavior, access to care), or survival probabilities of at-risk fetuses. More likely, a lack of policy implementation planning and infrastructure led to acute income insecurity and stress during the rollout period, exacerbating the existing health inequalities it sought to address.
2007 年，澳大利亚实施了近年来最激进的福利改革，以保护儿童免受伤害为目标，将目标对准了原住民社区。“收入管理”政策强制要求原住民福利接受者将至少一半的政府转账用于必需品（如食物、住房），而减少用于非必需品（如酒精、烟草）的支出。通过利用该政策的交错推出，我们估计了在子宫内接触政策推出对出生体重的影响。我们发现，接触收入管理政策会使平均出生体重显著降低 85 克，并使低出生体重的风险增加 3 个百分点。这一发现不能用行为变化（生育、产妇风险行为、获得护理的机会）或风险胎儿的生存概率来解释。更有可能的是，缺乏政策实施规划和基础设施导致在推出期间出现严重的收入不安全和压力，加剧了该政策试图解决的现有健康不平等问题。
