Long-term social assistance recipients' experiences with an increased monthly payment: a qualitative pilot study.

AIMS: Ten long-term social assistance recipients in a Norwegian municipality received a greater-than-average fixed monthly payment for 12 months. This study aimed to explore whether these recipients with reduced administrative requirements and a fixed monthly payment that was greater than the average social assistance experienced reduced poverty, increased feelings of independence, better daily living, and an improved quality of life. METHODS: The study's explorative design included 20 qualitative, in-depth, semi-structured interviews and a longitudinal electronic survey for 12 months. The 10 participants had been selected by the local labour and welfare agency based on stringent criteria and are therefore not representative of social assistance recipients in general. Individual interviews were conducted during autumn 2021 and spring 2022. The interview data were analysed using systematic text condensation, and the survey results are presented using descriptive statistics. RESULTS: The participants included in the project described a reduced experience of poverty. They could buy additional items and set aside money, something they had not been able to do in the past, and meant a great deal to them. They expressed experiencing freedom, gaining a stronger sense of independence, and having lessened feelings of shame. Many of the participants described health issues that were incompatible with working. CONCLUSIONS: Being given this opportunity led to a feeling of increased dignity and greater inclusion in society among this selected group of participants. They appreciated the simplified conditions and reduced requirements for administrative matters. All expressed that spending 8 months without contact with the social welfare office was a liberation.

Oral health promotion and labour market prospects of socially disadvantaged and unemployed people - a randomised controlled trial.

BACKGROUND: Previous studies indicate that poor oral health may constitute a barrier for labour market success. This study examines whether an oral health promotion intervention has an effect on economic self-support, and proximity to the labour market, among socially disadvantaged unemployed people. METHODS: From April-June 2018, we enrolled 273 vulnerable people on welfare benefits into a randomised controlled trial. Participants were allocated to either control (n=159), or intervention (n=114). Intervention consisted of individual support to improve individuals' oral health by reducing significant barriers to dental care. Ten participants were excluded, leaving 263 participants (intervention n=110, control n=153) for analyses. A national register was used to assess economic self-support and proximity to the labour market within 1.5 years post-intervention. Items of information on health and socio-demographics were obtained from a questionnaire and from national registers. Logistic and multiple linear regression modelling was performed. RESULTS: Overall, higher frequencies of economic self-support and proximity to the labour market were found in the intervention group, although no significant results were seen for economic self-support alone. Adjusted models revealed significantly higher odds (odds ratio=1.85, 95% confidence interval 1.08-3.17) among the intervention group of achieving proximity to the labour market after 12 months. After 18 months, the intervention group had on average obtained 5 more weeks (95% confidence interval 0.02-9.99) with proximity to the labour market. CONCLUSIONS: Overall, the oral health promotion intervention had a positive effect on proximity to the labour market in the intervention group, especially within the first year of the study. Our findings suggest that interventions promoting oral health among socially disadvantaged and unemployed groups may contribute to social rehabilitation.

[Effect of combined diabetic retinopathy and cataract on instrumental functional activity of patients.]

A potential factor that significantly reduces the social activity of older people is visual impairment due to age-associated eye diseases - cataracts and diabetic retinopathy, which dominate in this age cohort. The aim of the study was to study the social activity of elderly patients with diabetic retinopathy and cataracts. According to a special questionnaire, 115 people 60-74 years old with combined cataract and diabetic retinopathy and 102 people 60-74 years old without ophthalmological diseases were questioned based on the Tambov branch of the MNTK «Academician S.N.Fedorov Eye Microsurgery¼. It was found that the average score of social activity in patients with cataract and diabetic retinopathy is statistically significantly lower, amounting to 3,10±0,08 points, versus 5,38±0,09 points in people without ophthalmopathology. The main reasons that reduce social activity in patients with visual impairment are problems with making various purchases and using public or personal transport. Factor analysis confirmed that the contribution of these reasons to the decrease in social activity is the highest and amounts to 0,876 and 0,708, respectively. Therefore, it is recommended to increase social assistance to patients with cataracts and diabetic retinopathy in solving the problems of using transport and purchasing various goods.

Social assistance programme impacts on women's and children's diets and nutritional status.

Investments in social assistance programmes (SAPs) have accelerated alongside interest in using SAPs to improve health and nutrition outcomes. However, evidence of how design features within and across programme types influence the effectiveness of SAPs for improving diet and nutrition outcomes among women and children is limited. To address this, we reviewed evaluations of cash, in-kind and voucher programmes conducted between 2010 and 2020 among women and children, and examined associations between design features (targeting, including household and individual transfers, fortified foods and behaviour change communication) and positive impacts on diet (diet diversity, micronutrient intake) and nutrition (anthropometric indicators, haemoglobin, anaemia) outcomes. Our review has several key findings. First, SAPs improve dietary diversity and intake of micronutrient-rich foods among women and children, as well as improve several nutrition outcomes. Second, SAPs were more likely to impact diet and nutrition outcomes among women compared with children (23/45 [51%] vs. 52/144 [36%] of outcomes measured). Third, in-kind (all but one of which included fortified foods) compared with cash transfer programmes were more likely to significantly increase women's body mass index and children's weight-for-height/length Z-score, and both women's and children's haemoglobin and anaemia. However, there is limited evidence on the effectiveness of SAPs for improving micronutrient status and preventing increased prevalence of overweight and obesity for all populations and for improving diet and nutrition outcomes among men, adolescents and the elderly. Further research in these areas is urgently needed to optimize impact of SAPs on diet and nutrition outcomes as countries increase investments in SAPs.

Does Socioeconomic status mediate the relationship between income loss and depression scores? Evidence from South Africa.

This paper examines the role of socioeconomic status (SES) in mediating the effect of job and household income loss on mental health during the COVID-19 pandemic. We note that even though job loss will invariably reduce household income, the relationship between these factors and mental health may be mediated by SES. Specifically, in the context of COVID-19 induced shock, job loss may not be a threat to survival for an individual with relatively high SES, while this is not the case for individuals with low SES. Our empirical analysis uses threshold regression under the assumption that the relationship between depressive symptoms and pandemic induced job/ income loss has a threshold effect. We find that job loss (but not the decline in household income) is a stronger predictor of poor mental health for individuals that live in households above a certain SES threshold. This suggests that the psychological trauma of job loss due to loss of identity and purpose outweighs the financial loss for individuals with higher SES. On the other hand, a decrease in household income (as against the loss of individual income) is a stronger predictor of poor mental health for individuals with lower SES. We argue that these findings are related to high-income inequality in South Africa. The results highlight the different implications of job loss and income loss for depressive symptoms in the context of high socioeconomic inequality.

[Care pathways and family caregivers]. / Parcours de soins et aidants familiaux.

In recent years, a number of actions have been carried out to develop assistance for caregivers in France. This assistance can be coordinated with the help of social services, which can be difficult for both the elderly person and their caregiver, for psychological reasons. If an adapted and rehabilitated care pathway is not put in place, the caregiver may be exposed to psychosocial risks.

[RESEARCH OF PROBLEMS OF MEDICAL AND SOCIAL WORK IN THE RUSSIAN FEDERATION (REVIEW OF DISSERTATIONS)].

The development of social work in the field of health protection (medical and social work) largely depends on the ongoing scientific research on this topic. The review presents an analysis of dissertations, which demonstrate research on various aspects of medical and social work as a professional activity. The analyzed studies cover a 25-year period from the beginning of the first dissertation work in this area. Dissertations were carried out within the framework of medical, sociological and pedagogical sciences, it is based on the interdisciplinary approach in the formation of the modern system of social work in the Russian Federation.

Social Assistance Programs and Birth Outcomes: A Systematic Review and Assessment of Nutrition and Health Pathways.

BACKGROUND: Poor birth outcomes are an important global public health problem. Social assistance programs that provide cash or in-kind transfers, such as food or vouchers, hold potential to improve birth outcomes but the evidence on their effectiveness has not been reviewed. OBJECTIVES: We systematically reviewed studies that used experimental or quasi-experimental methods to evaluate the impacts of social assistance programs on outcomes in low- and middle-income countries. METHODS: The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system was used to assess the certainty of the evidence for birth weight and neonatal mortality (most common outcomes reported). We summarized the evidence on hypothesized nutrition and health pathways of impact. RESULTS: We included 6 evaluations of 4 different cash transfer programs and 1 evaluation of a community-based participatory learning and action program that provided food and cash transfers. The 4 studies that assessed birth weight impacts found significant (P < 0.05) effects ranging from 31 to 578 g. Out of 3 studies that assessed neonatal mortality impacts, 2 found significant effects ranging from 0.6 to 3.1 deaths/1000 live births. The certainty of the evidence for both outcomes was rated as very low due to several methodological limitations. In terms of potential pathways, some studies documented positive effects on maternal diet, antenatal care (ANC) utilization, and delivery in a health facility. CONCLUSIONS: Better-designed evaluations are needed to strengthen the evidence base on these programs. Evaluation studies should elucidate underlying mechanisms of impact by including outcomes related to maternal diet, ANC seeking, use of skilled delivery, and women's empowerment in nutrition and health domains. Studies should also assess potential unintended negative consequences of social assistance, such as reduced birth spacing and excess pregnancy weight gain.

The role of provincial social policies and economic environments in shaping food insecurity among Canadian families with children.

Food insecurity, inadequate access to food due to financial constraints, affects 17.3% of Canadian children, with serious health repercussions. Capitalizing on the geo-temporal variation in social policies and economic environments across Canadian provinces between 2005 and 2018, we examined the association between provincial policies and economic environments and likelihood of experiencing food insecurity among households with children. Drawn from 13 years of the Canadian Community Health Survey, our sample comprised 123,300 households with below-median income with children under 18 in the ten provinces. We applied generalized ordered logit models on the overall sample and subsamples stratified by Low-Income Measure (LIM). Higher minimum wage, lower income tax, and lower unemployment rate were associated with lower odds of food insecurity in the overall sample. A hypothetical one-dollar increase in minimum wage was associated with 0.8 to 1.0-percentage-point decrease in probability of food insecurity. The probability of food security increased by 1.2 to 1.6 percentage points following a one-percentage-point drop in bottom-bracket income tax rate. One-percentage-point lower unemployment rate corresponded to 0.6 to 0.8-percentage-point higher probability of food security. Higher welfare income and lower housing price predicted lower likelihood of severe food insecurity in the below-LIM subsample. Higher sales tax and median wage predicted higher likelihood of food insecurity among above-LIM households. Income support policies, favorable labor market conditions, and affordable living costs were all related to reduced food insecurity among Canadian households with children. Policies that increase minimum wage, reduce taxes, and create jobs may help alleviate food insecurity.

Differences in income trajectories according to psychological distress and pain: A longitudinal study among Norwegian social assistance recipients.

Aim: Mental diseases and pain are serious public health problems and are a leading cause of disability worldwide. The aim of this study is to describe how pain and psychological distress separately and in combination are associated with four income trajectories over nine years in a cohort of long-term social assistance recipients (LTRs). Methods: A cohort of 456 LTRs from 14 municipalities in Norway were divided into four groups based on the presence or absence of pain and/or psychological distress. These were surveyed in 2005, and later linked by personal identification numbers to high-quality longitudinal administrative data covering the period 2005-2013. Methods include calculation of income statuses based on main sources of income, and multinomial logistic regression analysis. Results: In the group without pain and psychological distress, earnings from work as main source of income (14.6-38.0%) and disability benefits (2.9-16.1%) increased over the period. In the 'double burden' group the proportions who had social assistance as main income decreased (68.2-21.5%) and the proportions with disability benefits increased over time (5.6-36.6%). Only 27.2% of the total sample had earnings from work as their main income in 2013. Conclusion: LTRs are extra burdened by pain and psychological distress, and this has consequences for their life opportunities and income trajectories. This study indicates that the primary goal of the social assistance system, to make the clients self-sufficient, is hard to achieve. A better co-operation between health services and work-related services is needed.

[Some aspects of improving the medical and social rehabilitation of the elderly who permanently live in general-type boarding schools.]

The article reflects the age and gender structure of the contingent of elderly people living in a General boarding house. The most common diseases in this category of persons, the presence of a disability group and individual programs for rehabilitation (habilitation) of the disabled person were established. The need for medical care, including medicines, was studied. There is a need to improve measures for medical and social rehabilitation, including in improving the employment of this contingent of people and the development of their leisure time. Examples of positive experience in this area among other regions of the Russian Federation are given.

Administering the Union citizen in need: Between welfare state bureaucracy and migration control.

How to determine whether mobile Union citizens have a right to social assistance? Research has shown how Western European Member States have made efforts to restrict Union citizens' access to their welfare systems over the past decade, whereby lawful residence has increasingly become the linchpin for entitlement. Member States have responded strikingly differently, however, to the complex administrative puzzle of dealing with open borders, the ability to verify lawful residence and the right to social assistance over time. This article makes an analytical and empirical contribution to existing literature by asking how Member States adjust their welfare/migration administrations to fit the Union's free movement regime and what implications this has for Union citizens. Based upon comparative case studies into the administration of social assistance rights in Germany, Austria and the Netherlands, the article develops a typology of three different models of administering Union citizens' access to the welfare state: the form, signal and delegation models. Demonstrating how bureaucratic design impacts the stratification of social rights in the Member States in different ways, the article concludes that studying alternative administrative models offers important insights into the functioning of territorial welfare states in open border regimes.

[Some problems of creating a geriatric service in the regions.]

The article reflects the current state of geriatric care in the Russian Federation at the stage of formation of a three-level model of geriatric service. The problems in the organization of geriatric services at the regional level, including the problem of training the appropriate profile, the negative attitude of the elderly to geriatric departments and geriatrics in General. Measures to improve the work in this direction are proposed.

[State support to elderly citizens: which geriatric needs modern Russia? (Part 2).]

The publication continues to consider the cause-subsequent relationships of low efficiency of the state policy in the field of prolonging the period of active longevity altogether with unsystematic approaches to the formation and implementation of state programs. In the context of the analysis of the reasons for the insufficient effectiveness of existing state programs in the field of improving social support for senior citizens, geriatrics is positioned as an integral part of gerontology - an area of applied research that provides solutions to medical, social, psychological and other problems that arise among citizens of elderly. In particular, these problems are associated with the psychophysiological, socio-economic, educational, cultural and legal status of this category of citizens. Geriatric care and its status as a basic component of comprehensive medical and social assistance to senior citizens are formalized. The influence of gerontology and geriatrics in the process of providing systemic support for improving the quality of life of senior citizens, which is one of the priorities of Russian state policy, is substantiated. The motivation is the need to amend existing laws and regulations governing the provision of state support to senior citizens, systematic processing of existing government programs in this area, based on the use of a scientific approach to solving the problem of adapting the state to the aging processes of society.

[The sociological research methods in practice of medical social work].

The specificity of medical and social work as professional activity targeted to restoring, preserving and promoting population health determines related focus of research practice and interdisciplinary nature of research. In accordance with purpose of medical and social work, specificity of emerging research practice is related to the fact that comprehensive assistance in maintaining and promoting population health implies the presence in activities of social worker medical and social profile of psychological, pedagogical, legal, technological and research competence. The article also applies the concept of "professional social worker involved in the provision of medical and social assistance to the population." This concept has following meaning: these are citizens who work in the positions of "social worker" and "specialist in social work" in medical organizations and social service organizations of population, who have job function related to restoring, maintaining and improving population health in general, social and in particular social and medical services. Therefore, content of the problem field, choice of areas of scientific support is concerned to each of these aspects of activity and associated social reflection. The article presents the results of theoretical study of the role of sociological methods in implementation of medical and social work.

Geographic and socio-demographic predictors of household food insecurity in Canada, 2011-12.

BACKGROUND: Household food insecurity is a potent social determinant of health and health care costs in Canada, but understanding of the social and economic conditions that underlie households' vulnerability to food insecurity is limited. METHODS: Data from the 2011-12 Canadian Community Health Survey were used to determine predictors of household food insecurity among a nationally-representative sample of 120,909 households. Household food insecurity over the past 12 months was assessed using the 18-item Household Food Security Survey Module. Households were classified as food secure or marginally, moderately, or severely food insecure based on the number of affirmative responses. Multivariable binary and multinomial logistic regression analyses were used to determine geographic and socio-demographic predictors of presence and severity of household food insecurity. RESULTS: The prevalence of household food insecurity ranged from 11.8% in Ontario to 41.0% in Nunavut. After adjusting for socio-demographic factors, households' odds of food insecurity were lower in Quebec and higher in the Maritimes, territories, and Alberta, compared to Ontario. The adjusted odds of food insecurity were also higher among households reliant on social assistance, Employment Insurance or workers' compensation, those without a university degree, those with children under 18, unattached individuals, renters, and those with an Aboriginal respondent. Higher income, immigration, and reliance on seniors' income sources were protective against food insecurity. Living in Nunavut and relying on social assistance were the strongest predictors of severe food insecurity, but severity was also associated with income, education, household composition, Aboriginal status, immigration status, and place of residence. The relation between income and food insecurity status was graded, with every $1000 increase in income associated with 2% lower odds of marginal food insecurity, 4% lower odds of moderate food insecurity, and 5% lower odds of severe food insecurity. CONCLUSIONS: The probability of household food insecurity in Canada and the severity of the experience depends on a household's province or territory of residence, income, main source of income, housing tenure, education, Aboriginal status, and household structure. Our findings highlight the intersection of household food insecurity with public policy decisions in Canada and the disproportionate burden of food insecurity among Indigenous peoples.

The impact of social assistance programs on population health: a systematic review of research in high-income countries.

BACKGROUND: Socioeconomic disadvantage is a fundamental cause of morbidity and mortality. One of the most important ways that governments buffer the adverse consequences of socioeconomic disadvantage is through the provision of social assistance. We conducted a systematic review of research examining the health impact of social assistance programs in high-income countries. METHODS: We systematically searched Embase, Medline, ProQuest, Scopus, and Web of Science from inception to December 2017 for peer-reviewed studies published in English-language journals. We identified empirical patterns through a qualitative synthesis of the evidence. We also evaluated the empirical rigour of the selected literature. RESULTS: Seventeen studies met our inclusion criteria. Thirteen descriptive studies rated as weak (n = 7), moderate (n = 4), and strong (n = 2) found that social assistance is associated with adverse health outcomes and that social assistance recipients exhibit worse health outcomes relative to non-recipients. Four experimental and quasi-experimental studies, all rated as strong (n = 4), found that efforts to limit the receipt of social assistance or reduce its generosity (also known as welfare reform) were associated with adverse health trends. CONCLUSIONS: Evidence from the existing literature suggests that social assistance programs in high-income countries are failing to maintain the health of socioeconomically disadvantaged populations. These findings may in part reflect the influence of residual confounding due to unobserved characteristics that distinguish recipients from non-recipients. They may also indicate that the scope and generosity of existing programs are insufficient to offset the negative health consequences of severe socioeconomic disadvantage.

[A study of social assistance for patients with occupational diseases].

Since the reform and opening up, a large number of migrant workers to enter into the mining enterprises of the town, due to poor working conditions and lack of awareness of labor protection, a large number of workers at that time were diagnosed with occupational diseases such as pneumoconiosis, the lack of effective treatment and compensation mechanisms, it faces many difficulties of life, health care, employment and marriage, becoming more vulnerable, need access to national and social support and assistance. Currently, the patient's occupation of social assistance there are some flaws, and for the growing demand for professional rescue patients, China is still not established specifically for the social assistance system of the patient career, but also lack of systematic research. The paper combing through social assistance in the form and content of the existing occupation for patients and found deficiencies and problems of the current social assistance vocational patient exists, and proposed a framework for the establishment of vocational social assistance system of the patient, specific measures and means.

Social welfare related to AIDS in Brazil: factors associated with social assistance and social security, 2004 - 2016.

OBJECTIVE: To describe the occurrence of social welfare benefits related to AIDS in Brazil and to compare the characteristics of the beneficiaries of social assistance and social security in 2004 - 2016. METHODS: This was an observational, analytical study based on secondary data obtained from the Ministry of Social Security of Brazil. Sociodemographic and epidemiologic characteristics of the beneficiaries of AIDS-related social assistance and social security were analyzed. RESULTS: From 2004 - 2016, a total of 99 369 benefits were granted, the majority of which were sick pay (64%), followed by social assistance benefits (26.5%) and disability retirement (8.1%). At the time that benefits were initiated, 51% of the individuals were unemployed. Those living in urban areas, females, the young, the elderly, and residents of the North and Northeast received more social assistance benefits. Duration of social assistance benefits (average 4 589 days) was greater than that of social security benefits (302 days). Survival among women (578 months) was greater than among men (311 months). CONCLUSIONS: In Brazil, the profile of social welfare beneficiaries living with AIDS reveals their social vulnerability. Controlling AIDS should be a priority on public agendas, aiming to minimize the disease's social and economic impact, especially on public health, social security, and social assistance.

Social and economic consequences of alcohol use disorder: a longitudinal cohort and co-relative analysis.

BACKGROUND: Although alcohol use disorder (AUD) is associated with future risk for psychosocial dysfunction, the degree to which this arises from a direct causal effect of AUD on functioning v. from correlated risk factors (also known as confounders) is less clearly established. METHOD: AUD was assessed from Swedish medical, criminal and pharmacy registries. In a large general population cohort, using Cox proportional hazard and regression models, we predicted from the onset of AUD four outcomes: early retirement, unemployment, social assistance, and individual income. We then examined the degree to which these associations were attenuated by relevant confounders as well as by the use of discordant cousin, half-sibling, full-sibling, and monozygotic twin pairs. RESULTS: In males, AUD most strongly predicted social assistance [hazard ratio (HR) 8.27, 95% confidence interval (CI) 7.96-8.59], followed by early retirement (HR 5.63, 95% CI 5.53-5.72) and unemployment (HR 2.75, 95% CI 2.65-2.85). For income at age 50, AUD was associated with a decrease in income of 0.24 s.d.s (95% CI -0.25 to -0.23). Results were similar in females. Modest to moderate attenuation of these associations was seen in both sexes after the addition of relevant covariates. These associations were reduced but remained robust in discordant co-relative pairs, including monozygotic twins. CONCLUSIONS: Our results suggest that AUD has a causal impact on a range of measures reflective of psychosocial dysfunction. These findings provide strong support for the drift hypothesis. However, some of the associations between AUD and dysfunction appear to be non-causal and result from shared risk factors, many of which are likely familial.