Exploring the Relationship between Welfare Participation in Childhood and Depression in Adulthood

Objective: Depression is one of the most prevalent mental health disorders among U.S. youth, and therefore, untangling the causal agents is a major public health priority. However, a growing body of research suggests that depression disproportionately affects women and those in lower socioeconomic strata. To address this economic health disparity, this study examines the relationship between participating in welfare programs during childhood (before age 18 years) experiencing depression during young adulthood.

Method: This study uses data from the National Longitudinal Study of Adolescent to Adult Health (N = 15,701) collected in Wave I (1993-94) and Wave IV (2008). Multiple imputation (m = 20) is used to deal with missing data. Propensity score matching is used to reduce the selection bias of the two groups (welfare recipients vs. non-recipients). The imputed and matched data are then analyzed using logistic regression (for the clinical diagnosis of depression [1= yes; 0=no]) and ordinary least square regression (for the self-reported depression score. In addition, subgroup analyses include examinations by household income levels (poor, near poor, and non-poor) and two gender groups.

Results: Overall, young adults from welfare-recipient families have significantly higher depression scores, and have no significant group differences on the diagnosed depression outcome. In addition, among welfare-recipient families, only the poor household group had significantly higher depression scores, whereas only the near-poor group had a significantly higher probability of being diagnosed with depression. With respect to gender, only adult females from welfare-recipient families had significantly higher depression scores, compared to males. Furthermore, no significant differences between female and male groups concerning diagnosed depression outcome.

Discussion: Using welfare participation as an economic marker, the subgroup analyses help to identify target populations for future intervention. This study has implications to inform welfare policymakers with policy recommendations for expanding Medicaid coverage for mental health treatment.