Abstract
Introduction
Temporary Assistance for Needy Families requirements can be stress-inducing, difficult for families to complete, and may be detrimental during early life. We assessed the impact of TANF requirements on primary caregiving mothers’ experiences of material hardship, anxiety, depression, and parental aggravation in the first year of a child’s life.
Methods
Survey responses were selected from mothers in the Future of Families and Childhood Wellbeing Study, who received TANF in the first year of their child’s life (N = 1085).
Results
Survey-weighted regression models showed associations between: presence of any requirements and increased material hardship, work requirements and increased material hardship, requirement to name the father of their child and increased depression, benefit cuts and increased parental aggravation, and benefit cuts and increased material hardship.
Discussion
Federal and state policies should revise requirement programs to increase program accessibility and support the mental health and financial stability of mothers applying for TANF to facilitate sustainable movement into employment.
Keywords: TANF, Welfare benefits, Benefit requirements, Maternal mental health, Policy
Introduction
Women who experience poverty and its associated stressors are more likely to experience poor mental health, intimate relationships characterized by violence, and involvement with the Child Welfare System (Davis, 2019; Pavetti, 2018). Evolving from the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Temporary Assistance for Needy Families (TANF), a conditional cash transfer and block grant program, directly serves approximately 1 million families experiencing poverty per year (US Department of Health & Human Services, 2019). In the adoption of TANF, federal legislators turned welfare from an entitlement program, formerly known as Aid to Families with Dependent Children (AFDC), to short-term support managed by state-governments and aimed at decreasing TANF use through adult employment. In the institution of TANF, the federal government capped federal contributions to 16.5 billion dollars annually and devolved significant control of the welfare program to state governments, which are required to provide matching funds and allowed to determine how funds are allocated and dispersed within a federal framework (Falk, 2012; US Department of Health & Human Services, 2019). Namely, states may allocate TANF funding to achieve federal goals for TANF, including the following purposes: “provide assistance to needy families so that children can be cared for in their own homes or in the homes of relatives, end the dependence of needy parents on government benefits by promoting job preparation, work, and marriage, prevent and reduce the incidence of out-of-wedlock pregnancies, and encourage formation and maintenance of two parent families” (US Department of Health & Human Services, 2019). In general, states achieve these goals by providing direct cash payments, rental assistance, childcare vouchers, and job training and educational assistance to individuals experiencing poverty, but also by funding social and other economic programs benefiting those who are not necessarily experiencing poverty (Schott et al., 2015). For individuals in direct receipt of TANF for themselves or a member of their family, state lawmakers determine the generosity of direct cash payments, eligibility criteria, and conditions or requirements of receipt. Requirements for TANF benefits can consist of reporting of pay stubs, logging of hours working or spent looking for work, or even naming of the non-custodial parent of the child receiving support, establishing paternity, identifying parental resources, and modifying child support orders at the discretion of individual states and counties (Roberts, 2005; US Department of Health & Human Services, 2019). States and counties impose sanctions, or financial reductions in TANF benefits, on TANF recipients in an effort to reinforce “personal responsibility” and compliance with work and child support-related requirements to maintain benefits (US Department of Health & Human Services, 2019).
The Family Stress Model
Previous studies have demonstrated that states that increase both TANF benefit requirements and harsher sanctions have significant deleterious health effects among low-income families, particularly affecting low-educated single mothers’ mental health, physical health, substance abuse rates, and exposure to violence, without little evidence showing increase in employment (Davis, 2019; Pavetti, 2018). We expand on prior evidence guided by the Family Stress Model to understand how family systems can be affected by and adapt to experiences of TANF benefit requirements as stressors which affect parental mental health, emotional resources, as well as parenting behaviors and attitudes (Conger et al., 2000). This model provides a theoretical lens to test how the experience of increased stressors related to completing specific benefit requirements or facing benefit sanctions at the policy level affects family systems and maternal outcomes of material hardship, mental health, and child-facing parental aggravation. An adaptation of the Family Stress Model, representing the conceptual model of the current study, is provided in Fig. 1.
Fig. 1.
Conceptual Model for TANF Requirements and Sanctions affecting maternal mental health, material hardship, and parental aggravation outcomes incorporating Family Stress Model (Represented by solid blue arrows) represent
Material hardship is included as a measure of the impact of low-income on uncertain living conditions based on shelter, medical care, food, and clothing (Office of the Assistant Secretary for Planning and Evaluation, 2004). Requirements to meet and maintain TANF can often be confusing and burdensome to recipients, during which recipients must spend time logging and meeting work hour quotas, or fulfilling requirements. Federally-funded studies have demonstrated that there are often significant administrative limitations at the local level to fully communicate with families in order to provide adequate accommodations or strategies to encourage financial stability for families facing difficulties with requirements or under threat of benefit sanctions (Brown, 2000). Benefit requirements, whether related to work or job seeking, education, or child-support cooperation, can cause intense forms of economic stress during which the financial future of the family system is uncertain (Pavetti, 2018).Previous research utilizing the Family Stress Model has substantiated impacts of economic stress and house-hold income during early childhood (year 1) on not only material hardship, but subsequently on maternal depression and harsher parenting styles (Shelleby, 2018). Work-related requirements, such as reporting and verifying of work hours, job searches, and pay stubs, can significantly strain mothers’ physical and mental health as they seek to balance the demands of childcare needs with strict hour quotas to maintain benefits (Hildebrandt, 2002). A recent study demonstrated that lower educated mothers living in states with higher stringency of TANF requirements, including job search and work requirements, had an estimated 1.5 more days of mental ill-health per year than mothers in states with less stringent TANF requirements (Davis, 2019).
The financial uncertainty and stress related to completing benefit requirements affects mothers, which can contribute to child-facing outcomes through the construct of parental aggravation. Parental aggravation is characterized by frustration, harshness, anger, or exhaustion with parenting roles and responsibilities, which are often exacerbated by stressful experiences in navigating welfare program requirements, and mental health challenges (Macomber et al., 2016; Suh & Luthar, 2020). Parental aggravation predicts internalizing and externalizing outcomes of child maladjustment to an extent similar to common measures of adverse child events (ACEs), but is a potentially more accessible and contemporaneous outcome to study and intervene on in the context of TANF requirements and sanctions, where stress induced by sudden reductions in financial support could increase the prevalence of contemporaneous parental aggravation (Suh & Luthar, 2020). Furthermore, parental aggravation offers an ability to explore parental mechanisms in the process of linking parental stressors, communication, and wellbeing to child outcomes as it brings in a parent-focused approach that studies on ACEs typically do not (National Academies of Sciences, 2019). While prior studies have examined the overall effects of TANF sanctions and stringency on maternal health outcomes (Davis, 2019), we expand on this evidence by examining multiple distinct TANF benefits requirements. Making use of the variation in these requirements across states using the nationally representative Future of Families and Childhood Wellbeing Study, we provide additional contributions by evaluating the relationship between specific requirements and a wider range of theoretically informed outcomes: maternal experiences of material hardship, mental health outcomes, and parental aggravation during a child’s first year of life.
Methods
Study Design and Population
Data utilized in this study came from the second wave (Year 1) of the Future of Families Child and Wellbeing Study (FFCWS, formerly Fragile Families and Child Wellbeing Study), a longitudinal cohort study that began in 1998 and has continued following families and nearly 5000 children born in a collection of 20 large US cities between 1998 and 2000 to understand the needs, strengths, socioeconomic and political factors related to the health and wellbeing of families. Mothers and fathers were recruited for the study around the time of the “focal child” birth within randomly selected “nonmarital births” from city hospitals. FFCWS has been repeated over six waves, administered around the time of each child’s birth, Year 1, Year 3, Year 5, Year 9, and Year 15 survey data, with Year 22 survey data set to be available in 2024. The FFCWS was constructed to be a nationally representative sample that could be used to generalize the impacts of urban socioeconomic and political impacts on family and child development among cities with over 200,000 people.
A pool of 77 selected cities with over 200,000 population were characterized into nine unique cells by dimensions of welfare generosity and labor market size, which were then randomly selected to 20 US cities aimed at maximizing policy welfare generosity and labor market variability to facilitate the study of US safety net policies. (Public Data Documentation, Future of Families and Child Wellbeing Study, 2023). Survey respondents are assigned sample weights in order to allow representativeness of US cities with over 200,000 residents.
Using FFCWS data, this study assessed outcomes for mothers who reported receiving TANF in the past year (N = 1085), roughly 22% of mothers during Year 1 data collection. Mothers are primary adult TANF recipients, according to TANF program audits (US Department of Health and Human Services, 2020). This group of mothers reporting TANF receipt was used as the analytic sample to examine effects of policy differences and minimize selection bias, rather than to compare differences between TANF recipients to non-recipients. Data when the focal child was approximately one year old was used for this study in order to capture a year of parenting experience during a crucial developmental period for children and mothers where outcomes of interest (depression, anxiety, parental aggravation, and material hardship events) have particularly strong impacts on developmental trajectories (Mughal et al., 2018; Shelleby, 2018). Additionally, Year 1 data had the benefit of a larger sample size, with least respondent attrition. Wave Response rate was overall high for Wave 1, which successfully interviewed 89% of mothers and 88% of fathers recruited in the baseline sample. (Public Data Documentation, Future of Families and Child Wellbeing Study, 2023).
Measures
Predictor Variables
Predictor variables included different ways of measuring TANF benefit conditionality and requirements. A dichotomous variable was used to assess whether or not mothers reported the general experience of “having to do anything” to receive benefits, which we defined as “Mothers with Conditional Benefit Requirements”. To assess the impact of specific benefit requirements, we included a collection of variables to assess the specific types and extent of benefit conditionality experienced by mothers. Due to inadequate cell size in some types of requirements (work in an unpaid job, n = 12), we focused on four specific types of benefit requirements for regression analyses, which consisted of dichotomous questions asking whether recipients were required to: (1) look for a job, (2) work in a paid job, (3) name father of child, and (4) attend school. In addition to assessing each of these separately as predictor variables, an additional predictor variable was constructed to sum the presence of each of the 4 total requirements asked of respondents in the FFCWS survey as a count variable (range 0–4) titled “Number of requirements indicated to maintain TANF”. Finally, a dichotomous variable was used to assess whether or not mothers experienced a sanction, or had benefits cut or reduced anytime in the past 12 months because they did not fulfill some type of requirement.
Outcome Variables
Material hardship events were assessed via a count variable that indexes 12 dichotomous variables related to mother’s experiences of material hardship in the last year. Drawing from questions in the 1999 New York City Social Indicators Survey (SIS), items included last year’s experience of failure to pay rent or mortgage, evictions, missed payments, utility cut-offs, receipt of charity support, and food insecurity (Meyers & Garfinkel, 2007). Since scale scoring methods have not been established for its use in the FFCWS study, the individual dichotomous variables were summarized as an indexed count variable. The reliability of scores in this sample was moderate (Cronbach’s alpha = 0.69).
Maternal anxiety was assessed via a dichotomous variable that represented whether mothers scored within the threshold of having anxiety based on the Mental Health for Generalized Anxiety Disorder portion of the CIDI-SF scale, used by the WHO to demonstrate acceptable internal consistency among US populations (Cronbach’s alpha = 0.89) (Gigantesco & Morosini, 2008).
Maternal depression was assessed via a dichotomous variable that represented whether mothers scored within the conservative threshold of having depression based on the Mental Health Depression section of the same CIDI-SF scale used to assess Generalized Anxiety Disorder (Cronbach’s alpha = 0.89) (Gigantesco & Morosini, 2008).
Parental aggravation was assessed via average responses from survey items taken from the JOBS (Job Opportunities and Basic Skills Training Program) Child Outcomes Study (Hagen & Lurie, 1993). Four of the nine original four-point Strongly agree-Strongly disagree parental aggravation items were used in this wave: “(Child) seems harder to care for than most children”, “There are some things that (he/she) does that really bother me a lot”, “I find myself giving up more of my life to meet (Child)’s needs than I ever expected”, and “I often feel angry with (child)”. Scores of these four items were reverse-coded so that higher scores reflected increased agreement with statements of parental aggravation, and average scores of the four items were used for regression analyses. Reliability of scores in this sample were moderate (Cronbach’s alpha = 0.63). These parental aggravation items have also been utilized in the Child Development Supplement to the Panel Study of Income Dynamics, which has been used in the development of over 400 manuscripts and research publications dedicated to studying the impacts of US economics and policies on family and child health and wellbeing (Hofferth et al., 2018).
Analysis
We used a series of logistic and linear regression models to calculate adjusted odds ratios and regression coefficients for the outcomes of material hardship events, anxiety, depression, and parental aggravation. Separate models on each of these outcomes were run for each predictor variable to assess the impacts of mothers reported having at least one specific conditional benefit requirement, the total number of conditional requirements to maintain benefits reported, whether mothers reported having the specific requirements of: look for a job, work in a paid job, name the father of child, and whether mothers had reported losing benefits over the past year. All models were adjusted control for differences in covariates of mothers age, education, race (Black, White, Other, simplified to account for small cell sizes), Hispanic ethnicity, marital status (simplified as married vs not married upon completing the Year 1 survey), and poverty level (as % of federal poverty level). To account for the FFCWS study’s complex survey design, all models were estimated using SAS SURVEY procedures and weighted at the city level to generalize sample demographics to match their city population frequencies. The [Author Institution name withheld for peer review] Institutional Review Board (IRB) approved the study.
Results
The average age for mothers receiving TANF (N = 1085) was 23.89 years. The majority (69.41%) of mothers in this sample self-identified as black. The majority of mothers (59.85%) reported the presence of at least one requirement to maintain benefits. While having one requirement was most common (40.35%), many mothers reported needing to fulfill two or more requirements (19.55%). Of the sample, 18.32% of mothers experienced benefits being cut or reduced due to not meeting requirements. Table 1 includes additional descriptive statistics for predictor and outcome variables.
Table 1.
Survey weighted characteristics of mothers receiving TANF benefits
| Variable | N (Weighted %) | 95% CI for % with Survey Weights |
|---|---|---|
| Total mothers receiving TANF | 1085 | |
| Mean age of mother at first child birth (Baseline) | 23.89 years | (23.27, 24.51) |
| Mothers with welfare benefits conditional requirements | ||
| “Were you required to do anything in return for welfare benefits? | 651 (61.71%) | (56.65%, 66.76%) |
| Number of requirements to receive benefits | ||
| 0 | 422 (40.15%) | (35.24%, 45.05%) |
| 1 | 434 (40.30%) | (36.14%, 44.47%) |
| 2 | 155 (15.27%) | (10.61%, 19.93%) |
| 3 or more | 46 (4.28%) | (1.48%, 7.08%) |
| Types of benefit requirement reported | ||
| Required to look for a job | 238 (21.83%) | (17.45%, 26.20%) |
| Required to work in a paid job | 184 (19.12%) | (14.78%, 23.45%) |
| Name father of child | 211 (17.75%) | (13.67%, 21.84%) |
| Attend school | 248 (24.96%) | (19.57%, 30.34%) |
| Mothers whose benefits were reduced or cut in last year due to not fulfilling requirements | 175 (18.32%) | (15.85%, 20.78%) |
| Poverty level (% of federal poverty level) | ||
| 0–49% | 513 (47.95%) | (42.07%, 53.83%) |
| 50–99% | 255 (25.26%) | (19.19%, 31.33%) |
| 100–199% | 210 (20.53%) | (15.45%, 25.60%) |
| 200–299% | 65 (4.88%) | (2.81%, 6.95%) |
| 300%+ | 23 (1.39%) | (0.73%, 2.05%) |
| Education level | ||
| Less than HS | 476 (47.16%) | (39.04%, 55.28%) |
| HS or equivalent | 346 (30.82%) | (24.09%, 37.54%) |
| Some college or technical school | 231 (21.58%) | (15.06%, 28.10%) |
| College or graduate school | 11 (0.36%) | (0.10%, 0.63%) |
| Marital status | ||
| Married | 71 (8.88%) | (4.24%, 13.53%) |
| Unmarried | 994 (91.12%) | 86.47%, 95.76%) |
| Parental aggravation average score | 2.25 | (2.17, 2.34) |
| Mental health outcomes | ||
| Mother meets CIDI anxious criteria | 35 (2.31%) | (1.23%, 3.39%) |
| Mother meets CIDI depression criteria | 172 (14.55%) | (10.44%, 18.66%) |
| Race | ||
| Black | 742 (69.41%) | (61.23%, 77.61%) |
| White | 164 (12.48%) | (9.03%, 15.93%) |
| Other | 151 (18.10%) | (11.80%, 24.40%) |
| Hispanic or Latino origin or descent | ||
| Yes | 214 (20.99%) | (14.29%, 27.69%) |
| No | 844 (77.86%) | (70.71%, 85.01%) |
| Material hardship events | ||
| (Number of material hardship events in past year) | 1.42 | (1.28, 1.58) |
Adjusted model results are displayed in Table 2. We found that mothers who reported being required to do anything to receive TANF benefits experienced 0.512 (0.090, 0.933) more material hardship events. Mothers who experienced work requirements for TANF receipt had experienced 0.454 (0.107, 0.801) more material hardship events during the first year of their child’s life. Mothers required to name the father of their child had 1.814 (1.10, 3.00) times the odds of meeting the criteria for clinical depression. Mothers whose benefits were cut during the child’s first year of life also reported an increase of 0.618 (0.047, 1.19) material hardship events and 0.199 (0.003, 0.396) higher scores of the parental aggravation scale.
Table 2.
Logistic and linear regression models: adjusted city-weighted ORs (95%CI) or weighted regression coefficients (95% CI)
| Meets anxious criteria | Meets depression criteria | Parental Aggravation Scale | Material Hardship Events | |
|---|---|---|---|---|
| Mothers with welfare benefits requirements | 2.409 (0.892, 6.503) | 1.074 (0.657, 1.757) | 0.132 (− 0.074, 0.338) | 0.512 (0.090, 0.933)* |
| Number of requirements indicated to maintain benefits | ||||
| 1 vs 0 Requirements | 2.324 (0.842, 6.411) | 0.930 (0.580, 1.492) | 0.161 (− 0.056, 0.377) | 0.371 (− 0.134, 0.877) |
| 2 vs 0 Requirements | 2.869 (0.690, 11.922) | 1.277 (0.554, 2.946) | 0.071 (− 0.145, 0.288) | 0.476 (− 0.187, 1.139) |
| > 2 vs 0 Requirements | 1.196 (0.138, 10.367) | 2.961 (0.652, 13.449) | 0.331 (− 0.067, 0.729) | 0.372 (− 0.200, 0.944) |
| Required to look for a job | 1.543 (0.619, 3.846) | 0.802 (0.389, 1.652) | 0.176 (− 0.060, 0.413) | 0.321 (− 0.105, 0.746) |
| Required to work in a paid job | 1.499 (0.650, 3.457) | 1.210 (0.568, 2.577) | 0.168 (− 0.087, 0.425) | 0.454 (0.107, 0.801)* |
| Name father of child | 2.352 (0.971, 5.697) | 1.814 (1.098, 2.998)* | 0.007 (− 0.257, 0.271) | − 0.001 (− 0.599, 0.597) |
| Attend school | 0.660 (0.218, 1.997) | 1.275 (0.726, 2.241) | 0.013 (− 0.161, 0.187) | 0.062 (− 0.389, 0.514) |
| Mothers whose benefits were reduced or cut due to not fulfilling requirements | 1.720 (0.763, 3.876) | 1.388 (0.616, 3.128) | 0.199 (0.003, 0.396)* | 0.618 (0.047, 1.190)* |
Mothers with Conditional Benefit Requirements asked “Were you required to do anything in return for welfare benefits?”
Results of the adjusted models showed similar point estimates and confidence intervals as our crude models, while adjusting for race, income level (as % of federal poverty level), and age
p is significant at < 0.05 value
p is significant at < 0.0001 value
Discussion
Our findings are consistent with theorized relationships guided by the Family Stress Model, as well as with previous studies that found U.S. states that increase both TANF benefit requirements and harsher sanctions have negative consequences for mental health, physical health, and other negative economic stressors for mothers (Davis, 2019; Holcomb et al., 2017; Pavetti, 2018). Our study adds to the literature by highlighting the importance of child support cooperation requirements in that mothers required to name the father of the child was associated with nearly double the odds of reporting criteria for depression. Further investigation is needed to assess differences in state-level legal processes for establishing paternity and how that affects stress among mothers across different states. This is especially important for families experiencing intimate partner violence, for which previous research has demonstrated a historic lack of adequate support, assessment, and accommodation within TANF (An & Choi, 2019; Holcomb et al., 2017; Spencer et al., 2021).
The observed increase in material hardship events associated with work requirements reinforces prior work that the experience of navigating the requirement system or even the threat of potentially losing benefits via requirements may impact material hardship events through reducing discretionary time or delayed payments on essential items out of fear of financial uncertainty (Pavetti, 2018; Turner & Grieco, 2000). Furthermore, our analyses on the impacts of losing benefits as a result of sanctions is in line with previous research demonstrating the increased risk of experiencing material hardship and negative childcare outcomes for mothers losing TANF benefits (Kalil et al., 2002).
This study is one of the first to assess TANF requirement impacts on maternal mental health with a nationally representative, large sample of women who received TANF, allowing for the evaluation of separate elements of TANF requirements across U.S. states. Further, this study is one of the few to date that have examined separate types of requirements and their effects on the lived experiences of mothers during the critical period of the first year of their child’s life. Our analyses add further evidence of the utility of the Family Stress Model in assessing relationships between family economic policies, caregiver wellbeing, family systems, and key child-facing parenting outcomes. Future studies should seek to explore the relationships described in this study more in-depth by utilizing dyadic modeling approaches to assess the impact of TANF or other family economic policies on outcomes reported by secondary caregivers, which in this sample were fathers. Additionally, incorporating the measure of inter-partner violence would be beneficial in future studies incorporating the Family Stress Model, utilizing similar methods as outlined by Adhia and Jeong, who utilized FFCWS data (Adhia & Jeong, 2019). Difference-in-difference approaches may also be useful to further understand the complexities of how the exposure to policy-related stressors like TANF requirements may affect future parental and child wellbeing outcomes developmentally across the multiple waves of FFCWS data collection (Ash et al., 2023).
While this study offers insights into relationships between economic policies and family outcomes, it is not without limitations. It is unclear whether our results may be influenced by requirements taking place in states with less generous TANF benefits, lower TANF-to-poverty ratios, or if TANF funding in these states may be diverted away from basic assistance and into other TANF interventions such as advocating for the prevention of out-of-wedlock pregnancies and marriage promotion (Burnside & Schott, 2017). While the FFCWS developed a robust, representative survey of outcomes related to mothers throughout key periods in child development, due to the all-urban sample meant to reflect policy and labor market variance, it may not accurately reflect the experiences of navigating TANF policy requirements for families in more rural areas.
Additional limitations of this study include the potential over-simplification of the race variable included in the models, which were broken into categories of Black, White, and Other. This simplification was intended to adjust for small cell sizes and was incorporated based on studies that have indicated that Black recipients of TANF are more likely to face sanctions for noncompliance than White recipients (Olson, 2019; Pavetti, 2018; Schram et al., 2009). Further work should be done to evaluate race-specific effects of TANF conditionality that may be due to underlying racialized discrimination in TANF policies and administration. One limitation to the cross-sectional design of this study is that it limits any ability to rule out the presence of potentially confounding bidirectional causal pathways between material hardships and benefit cuts/conditionality, or to determine if events of material hardship occurred before or after any potential stressors incurred by a sudden loss of benefits, additional specific benefit requirements, or by other confounders.
Conclusion
Results highlight a need for national policy to address differences in the process of requirements and sanctions in TANF across states. TANF programs should adapt recipient-responsive approaches to reduce barriers to services, administrative burden, to facilitate family participation in sustainable employment and to reduce the harm that is being done to families when they leave or are “pushed out” of TANF benefits. Families living in poverty also suffer from the lack of discretionary time, which is needed to navigate complicated benefit requirement systems (Turner & Grieco, 2000). Results from this study and the extant literature suggest that future studies on family policies consider protective and resilience-promoting factors for low-income mothers, such as requirements for schooling, intensive case management or higher cash benefits, to effectively guide intervention and policy development to support families during times of greatest financial need.
Supplementary Material
Significance.
Previous research has demonstrated negative health impacts associated with TANF implementation and distribution for low-income families. This study is one of the first to examine the relationship between experiencing specific TANF benefit requirements and maternal mental health, parental aggravation, and material hardship outcomes within a nationally representative sample. Findings showing significant associations between presence of requirements, driven by specific requirement types, with increased rates of material hardship, depression, and parental aggravation. Results suggest state level policy changes are needed to reduce unnecessary harm being done to vulnerable families.
Acknowledgements
Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) of the National Institutes of Health under award numbers R01HD036916, R01HD039135, and R01HD040421, as well as a consortium of private foundations. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Funding
This study was supported by funds from the National Center for Injury Prevention and Control (Grant No: R01CE003104, Award: Evaluating family economic policies as primary prevention strategies to prevent family and youth violence, PIs Woods-Jaeger and Livingston).
Footnotes
Supplementary Information The online version contains supplementary material available at https://doi.org/10.1007/s10995-023-03699-0.
Code Availability Code for analyses will be made available as a supplemental.SAS program file.
Conflict of interest We have no conflicts of interest to disclose.
Ethical Approval This study was approved by Emory University Institutional IRB.
Consent for Publication This article has not been published elsewhere. We consent for Child and Maternal Health Journal to publish this article upon acceptance.
Data Availability
Data must be requested through Fragile Families Child Wellbeing Survey (https://fragilefamilies.princeton.edu/).
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Supplementary Materials
Data Availability Statement
Data must be requested through Fragile Families Child Wellbeing Survey (https://fragilefamilies.princeton.edu/).