Extra cash from government program linked to better child development

March 7, 2008

Children in impoverished families that received an extra amount of cold, hard cash from a government support program were taller, less likely to be overweight, and scored higher on cognitive, motor and language tests, compared with kids in families that received less money, says a new study led by researchers at the University of California, Berkeley.

The study, to be reported in the March 8 issue of the journal Lancet, focused on low-income families enrolled in a conditional cash transfer program run by the Mexican government.

In traditional welfare programs, families receive cash benefits based upon their income or residence in specific geographic areas. Conditional cash transfer programs, in contrast, provide money to low-income families if they fulfill specific requirements, such as getting their children vaccinated and making sure they attend school. Some programs also provide food and nutritional supplements as part of the intervention.

"Previous research has shown positive outcomes for child development from conditional cash transfer programs, but the general assumption, particularly from the public health perspective, was that the improvements were the result of the health and education components rather than the cash," said lead author Lia Fernald, assistant professor in public health nutrition at UC Berkeley's School of Public Health. "This new study is the first to tease out the impact of the money from the other elements of the program."

While it was unclear exactly how the cash was being used, the researchers said the extra purchasing power could have allowed families to buy more food, medicine, toys or household goods.

The Mexican government was the first to launch a conditional cash transfer program, called Progresa, in 1997. The program, now called Oportunidades, serves more than 5 million Mexican families and has been replicated in more than 20 developing countries, primarily in Latin America and Africa.

Last year, New York City Mayor Michael Bloomberg announced the creation of Opportunity NYC, heralding the first conditional cash transfer program in a developed nation. Modeled after Oportunidades in Mexico, the New York City pilot program has already disbursed $740,000 to more than 1,400 families who have completed specific activities related to education, health and workforce participation and training.

"The goal of conditional cash transfer programs is to break the cycle of poverty by investing in human capital," said study co-author Lynnette Neufeld, director of the Division of Nutritional Epidemiology at the National Institute of Public Health in Mexico. "Cash is given to take care of a family's immediate, short-term needs, but the programs ensure that families are investing for the long term in things that can actually move children out of poverty, such as making sure children have optimal health, nutrition and education."

Budget and logistic constraints kept the Mexican government from enrolling all eligible families at once in its conditional cash transfer program. A random selection of eligible villages began participating, then other villages were phased in over an 18-month period. That meant that families enrolled first received more money cumulatively than those enrolled later.

Families whose children stayed in school longer received extra money. Children in grades 3 and higher and who maintained at least an 80 percent school attendance record received educational scholarships, and extra money also was given for girls as a way to promote female education. For each family, these benefits were capped after three children.

Only families whose kids had been enrolled their entire lives in Oportunidades were included in the study, which meant they all had equal exposure to the program's health and education components. The researchers controlled for the size and demographics of a household in their analysis.

The researchers estimated the difference between families who over the past 3.5 to 5 years had received an average of $800 - the median amount of cash disbursed to a household in the program - with those who had gotten twice that amount in the same time period.

They found that, compared with children in families who got less money, kids in families who got more cash were taller for their age group, were less likely to be overweight, and performed better on standardized tests for cognitive and motor development.

The researchers did not analyze just how the extra cash influenced child development, but suspect that the money may have allowed families to purchase more nutritious food or medicine, or perhaps to buy assets for the home such as a refrigerator or a covering for a dirt floor.

"Even the purchase of additional books or toys for the children - something we often take for granted in this country - could help stimulate cognitive development," said Fernald. "Also, the additional cash could have the psychological benefit of taking some of the pressure off of the mothers. These are families who are at the bottom 20th percentile in Mexico for household income. When relieved from the constant worry about not providing enough food for their children, mothers may feel less depressed and may be better able to interact with their children."

The researchers noted that despite these encouraging findings, the performance on child health and development measures for all the kids in the study remained poor relative to that for the country's broader population.

"This paper clearly says that increased cash is associated with better outcomes in kids, but we need to do better," said Fernald. "It may be hard to significantly increase the amount of cash given to each family, but as a major next step, it could be worth investigating whether tying the cash to more targeted child stimulation programs would help."

Source: University of California - Berkeley

Explore further: The hidden extra costs of living with a disability

Related Stories

The hidden extra costs of living with a disability

July 26, 2017
Disability is often incorrectly assumed to be rare. However, global estimates suggest than one in seven adults has some form of disability.

Not just for the poor—the crucial role of Medicaid in America's health care system

June 8, 2017
Despite many assertions to the contrary, Senate leaders are now saying they want to vote on the replacement bill for Obamacare before the month is out.

School districts rethink meal debt policies that shame kids

July 4, 2017
Teaching assistant Kelvin Holt watched as a preschool student fell to the back of a cafeteria line during breakfast in Killeen, Texas, as if trying to hide.

New highly virulent strain of ransomware cripples networks (Update 3)

June 27, 2017
A new, highly virulent strain of malicious software that is crippling computers globally appears to have been sown in Ukraine, where it badly hobbled much of the government and private sector on the eve of a holiday celebrating ...

Expert gives tips on how to prevent summer brain drain

July 7, 2017
Summer is a time when most students are able to relax and have fun away from the classroom, but it also can be a time when important lessons learned during the year are forgotten. A Baylor College of Medicine expert has some ...

For a health reform model, try Brazil

September 24, 2012
With the 2015 deadline to meet the United Nations' Millennium Development Goals (MDG) approaching, scholars and government officials gathered at the Harvard School of Public Health (HSPH) on Tuesday to search for lessons ...

Recommended for you

Americans misinformed about smoking

August 22, 2017
After voluminous research studies, numerous lawsuits and millions of deaths linked to cigarettes, it might seem likely that Americans now properly understand the risks of smoking.

Women who sexually abuse children are just as harmful to their victims as male abusers

August 21, 2017
"That she might seduce a helpless child into sexplay is unthinkable, and even if she did so, what harm can be done without a penis?"

To reduce postoperative pain, consider sleep—and caffeine

August 18, 2017
Sleep is essential for good mental and physical health, and chronic insufficient sleep increases the risk for several chronic health problems.

Despite benefits, half of parents against later school start times

August 18, 2017
Leading pediatrics and sleep associations agree: Teens shouldn't start school so early.

Doctors exploring how to prescribe income security

August 18, 2017
Physicians at St. Michael's Hospital are studying how full-time income support workers hired by health-care clinics can help vulnerable patients or those living in poverty improve their finances and their health.

Schoolchildren who use e-cigarettes are more likely to try tobacco

August 17, 2017
Vaping - or the use of e-cigarettes - is widely accepted as a safer option for people who are already smoking.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.