Financial benefits for child health and well-being in low income or socially disadvantaged families in developed world countries.

BACKGROUND: A strong and consistent relationship has been observed between relative poverty and poor child health and wellbeing even among rich nations. This review set out to examine evidence that additional monies provided to poor or disadvantaged families may benefit children by reducing relative poverty and thereby improving children's health, well-being and educational attainment. OBJECTIVES: To assess the effectiveness of direct provision of additional monies to socially or economically disadvantaged families in improving children's health, well-being and educational attainment SEARCH STRATEGY: In total 10 electronic databases were searched including the Cochrane library searched 2006 (Issue 1), Medline searched 1966 to May 2006 , Econlit searched 1969 to June 2006 and PsycINFO searched 1872 to June 2006, together with 3 libraries of working papers (MDRC, SSRN, SRDC). The general search strategy was [terms for income and financial benefits] and [paediatric terms] and [RCT filter] SELECTION CRITERIA: Studies selected provided money to relatively poor families (which included a child under the age of 18 or a pregnant woman), were randomised or quasi-randomised, measured outcomes related to child health or wellbeing and were conducted in a high income country. DATA COLLECTION AND ANALYSIS: Titles and abstracts identified in the search were independently assessed for eligibility by two reviewers. Data were extracted and entered into RevMan, synthesised and presented in both written and graphical form (forest plots). MAIN RESULTS: Nine trials including more than 25,000 participants were included in this review. No effect was observed on child health, measures of child mental health or emotional state. Non-significant effects favouring the intervention group were seen for child cognitive development and educational achievement, and a non-significant effect favouring controls in rates of teenage pregnancy. AUTHORS' CONCLUSIONS: The review set out to examine the potential of financial support to poor families to improve circumstances for children. However, on the basis of current evidence we can not state unequivocally whether financial benefits delivered as an intervention are effective at improving child health or wellbeing in the short term. Our conclusions are limited by the fact that most of the studies had small effects on total household income and that while no conditions were attached to how money was spent, all studies included strict conditions for receipt of payments. We note particular concerns by some authors that sanctions and conditions (such as working hours) placed on families may increase family stress.