Abstract
Background
Welfare programs provide income assistance to individuals whose resources are insufficient to meet their needs and who have exhausted all other avenues of support. With continued reductions in welfare in many provinces, the health of the nearly 2 million Canadians who rely on it may be compromised. This study examines the relationship between receipt of welfare and adult recipients’ general, mental and social health, and selected chronic conditions.
Methods
We undertook a secondary analysis of data from the 1996/97 National Population Health Survey. To differentiate between disabled and non-disabled welfare recipients, we stratified our analysis by long-term disability status as defined by selfreported restricted activity.
Results
After controlling for the potentially confounding effects of age, sex, and education, regardless of whether or not they reported restricted activity, adults on welfare when compared to those not on welfare had significantly higher odds of reporting poor/fair health, poor functional health, depression, distress, and poor social support. Among those without restricted activity, welfare recipients had greater odds of heart disease when compared to those not on welfare; no associations were observed between welfare status and obesity, diabetes, or hypertension.
Interpretation
These findings indicate that adults on welfare struggle with a broad spectrum of health problems; the increasing inadequacy of welfare benefits may put them at even greater health risk. The impact of welfare program reforms on the health and wellbeing of recipients must be assessed and monitored.
Résumé
Contexte
Les programmes d’aide sociale fournissent un soutien du revenu aux personnes dont les ressources sont insuffisantes pour répondre à leurs besoins et qui ont épuisé toutes les autres possibilités de soutien. Avec les compressions continuelles des budgets de l’aide sociale dans de nombreuses provinces, la santé des près de deux millions de Canadiens qui sont dépendants de cette aide pourrait être compromise. La présente étude porte sur la relation entre le statut d’assisté social, la santé générale, mentale et sociale des bénéficiaires adultes et certains états chroniques.
Méthode
Nous avons entrepris une deuxième analyse des données de l’Enquête nationale sur la santé de la population (1996–1997). Pour différencier les assistés sociaux atteints d’invalidité des assistés sociaux non atteints, nous avons stratifié l’analyse en fonction de l’état d’invalidité de longue durée, défini d’après les limitations fonctionnelles déclarées par les intéressés.
Résultats
Compte tenu des facteurs confusionnels que peuvent représenter l’âge, le sexe et le niveau d’instruction, et peu importe que les répondants aient ou non déclaré des limitations fonctionnelles, les assistés sociaux adultes étaient de manière significative plus susceptibles que les non-assistés de faire état d’une santé mauvaise ou moyenne, de problèmes de santé fonctionnelle, de dépression, de détresse et d’un piètre soutien social. Chez les personnes sans limitation fonctionnelle, les assistés sociaux avaient davantage tendance à être atteints de cardiopathies que les non-bénéficiaires de l’aide sociale; aucune association n’a été observée entre le statut d’assisté social et l’obésité, le diabète ou l’hypertension artérielle.
Interprétation
Ces constatations indiquent que les assistés sociaux adultes sont aux prises avec un vaste éventail de problèmes de santé; l’insuffisance croissante des prestations d’aide sociale pourrait les exposer à des risques sanitaires encore plus grands. L’incidence des réformes aux programmes d’aide sociale sur la santé et le bien-être des bénéficiaires doit donc faire l’objet d’une évaluation et d’un suivi.
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