Devaney B L, Ellwood M R, Love J M
Mathematica Policy Research, Inc., Princeton, NJ, USA.
Future Child. 1997 Summer-Fall;7(2):88-112.
This article reviews six federally funded in-kind public assistance programs that are intended to mitigate the effects of poverty on low-income children by providing access to basic human necessities such as food, housing, education, and health care. The evidence suggests that, while each program can be improved, these programs do achieve their basic objectives. In general, food stamps, the Special Supplemental Food Program for Women, Infants, and Children (WIC), and school nutrition programs are successful at providing food assistance to low-income children, starting with the prenatal period and continuing through the school years. The Food Stamp Program provides food assistance nationwide to all households solely on the basis of financial need and is central to the food assistance safety net for low-income children. The WIC program has helped reduce the prevalence of iron-deficiency anemia in infants and children and has increased intakes of certain targeted nutrients for program participants. The school nutrition programs provide free or low-cost meals that satisfy the dietary goals of lunches and breakfasts to most school-age children. The Medicaid program has extended health insurance coverage to millions of low-income children. However, many children remain uninsured, and children enrolled in Medicaid do not have the same access to medical care as privately insured children. Relatively little is known about the effects of Medicaid on children's health status. For Head Start, empirical evidence suggests that participating children show enhanced cognitive, social, and physical development in the short term. Studies of the longer-term impacts of Head Start are inconclusive. Although housing assistance improves housing quality and reduces housing costs for recipients, there is a large unmet need for acceptable, affordable housing among poor families. Important gaps remain in our knowledge of the effects of these programs on the well-being of children. Questions regarding a program's effects over time on health and developmental outcomes particularly need more study.
本文回顾了六项由联邦政府资助的实物公共援助项目,这些项目旨在通过提供诸如食品、住房、教育和医疗保健等基本生活必需品,来减轻贫困对低收入儿童的影响。有证据表明,虽然每个项目都有改进的空间,但这些项目确实实现了其基本目标。总体而言,食品券、妇女、婴儿和儿童特别补充食品计划(WIC)以及学校营养计划在为低收入儿童提供食品援助方面取得了成功,从孕期开始一直持续到上学期间。食品券计划仅根据经济需求在全国范围内为所有家庭提供食品援助,是低收入儿童食品援助安全网的核心。WIC计划有助于降低婴幼儿缺铁性贫血的患病率,并增加了项目参与者对某些特定营养物质的摄入量。学校营养计划为大多数学龄儿童提供免费或低成本的膳食,这些膳食符合午餐和早餐的饮食目标。医疗补助计划已将医疗保险覆盖范围扩大到数百万低收入儿童。然而,仍有许多儿童未参保,而且参加医疗补助计划的儿童无法像参加私人保险的儿童那样获得同等水平的医疗服务。关于医疗补助计划对儿童健康状况的影响,人们了解得相对较少。对于“启智计划”,实证证据表明,参与该计划的儿童在短期内认知、社交和身体发育都有所增强。关于“启智计划”长期影响的研究尚无定论。虽然住房援助提高了受助者的住房质量并降低了住房成本,但贫困家庭对可接受的经济适用房仍有大量未满足的需求。我们对这些项目对儿童福祉影响的了解仍存在重大差距。特别是关于一个项目随着时间推移对健康和发育结果的影响问题,尤其需要更多研究。