SEARCHSYSTEMATIC_REVIEWpublic health, epidemiology

systematic_review·public health, epidemiology, pediatrics, systematic review, cardiology·PMC10121417

The impact of income-support interventions on life course risk factors and health outcomes during childhood: a systematic review in high income countries

BMC Public Health · 6 authors, 5 centres

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TL;DR

This systematic review analyzed 16 studies to assess if income-support policies (like cash transfers and tax credits) delivered in the first 1,000 days of life improve child health outcomes in high-income countries. The review found small positive effects on birth weight but limited evidence for mental health improvements.

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The interventions evaluated were income-support policies like cash transfers, tax credits, and minimum wage increases delivered during the first 1,000 days of life. The narrative synthesis found a consistent, positive, albeit small, effect of most interventions on birth weight outcomes. Evidence for mental health was more mixed and limited, with the only RCT showing no effect. The authors note that while the individual effects are small, the large population exposure to these policies could mean a relevant public health impact. A key limitation is the limited generalizability of the evidence, with most studies from the US and Canada and a narrow range of outcomes investigated, leaving gaps for cardiometabolic and respiratory health.

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systematic_review

SPECIALTY

public health

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ORIGINAL PAPER

PMC10121417

The impact of income-support interventions on life course risk factors and health outcomes during childhood: a systematic review in high income countries

BMC Public Health

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ABSTRACT

Background In high income countries one in five children still lives in poverty, which is known to adversely shape the life course health trajectory of these children. However, much less is understood on whether social and fiscal policies have the capacity to reverse this damage, which intervention is likely to be most effective and when these interventions should be delivered to maximise their impact. This systematic review attempts to address these questions by looking at the impact of income-support interventions, delivered during the first 1,000 days of life, on cardiovascular, metabolic, respiratory and mental health outcomes. Methods The review was restricted to experimental or quasi experimental studies conducted in high income countries. Studies were retrieved from multidisciplinary databases as well as health, economic, social sciences-specific literature browsers. All papers retrieved through the search strategy were double screened at title, abstract and full text stage. Relevant data of the selected studies were extracted and collected in tables, then summarised via narrative synthesis approach. Robustness of findings was assessed by tabulating impact by health outcome, type of intervention and study design. Results Overall, 16 relevant papers were identified, including 15 quasi-experimental studies and one randomized control trial (RCT). Income-support interventions included were unconditional/conditional cash transfers, income tax credit and minimum wage salary policies. Most studies were conducted in United States and Canada. Overall, the evidence suggested limited effect on mental health indicators but a positive, albeit small, effect of most policies on birth weight outcomes. Despite this, according to few studies that tried to extrapolate the results into public health terms, the potential number of negative outcomes averted might be consistent. Conclusions Income-support interventions can positively affect some of the health outcomes of interest in this review, including birth weight and mental health. Given the large number of people targeted by these programs, one could infer that – despite small – the observed effect may be still relevant at population level. Nonetheless, the limited generalisability of the evidence gathered hampers firm conclusions. For the future, the breadth and scope of this literature need to be broadened to fully exploit the potential of these interventions and understand how their public health impact can be maximised. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-023-15595-x.

CITATION EXPORT

Delia Boccia, Silvia Maritano, Costanza Pizzi et al.. The impact of income-support interventions on life course risk factors and health outcomes during childhood: a systematic review in high income countries. BMC Public Health. (2023). https://doi.org/10.1186/s12889-023-15595-x

AUTHORS

6 · 5 CENTRES

Delia Boccia, Silvia Maritano, Costanza Pizzi, Matteo G. Richiardi, Sandrine Lioret, Lorenzo Richiardi

1https://ror.org/00a0jsq62grid.8991.90000 0004 0425 469XFaculty of Population and Health Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Pl, London, WC1H 9SH UK
2https://ror.org/048tbm396grid.7605.40000 0001 2336 6580Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin, Italy
3https://ror.org/0290wsh42grid.30420.350000 0001 0724 054XUniversity School for Advanced Studies IUSS Pavia, Pavia, Italy
4grid.8356.80000 0001 0942 6946Centre for Microsimulation and Policy Analysis, Institute for Social and Economic Research, University of Essex, Colchester, UK
5Université Paris Cité, INSERM, INRAE, Paris, CRESS France