ArticleThe Lancet. Public health2018
Effects of restrictions to Income Support on health of lone mothers in the UK: a natural experiment study.
Article in The Lancet. Public health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Preventing depression in high-income countries-A systematic review of studies evaluating change in social determinants.PloS one · 2025Pooled it
- Is Austerity Responsible for the Stalled Mortality Trends Across Many High-Income Countries? A Systematic Review.International journal of social determinants of health and health services · 2024Pooled it
- Health, poverty and employment effects of cutting income replacement benefits for the disabled: a difference-in-differences analysis of the 2017 welfare reforms.Journal of epidemiology and community health · 2026Article
- Understanding changes to life expectancy and inequalities in the UK, Germany, and other high-income countries.Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2025Review
- Using natural experiments to evaluate population health and health system interventions: new framework for producers and users of evidence.BMJ (Clinical research ed.) · 2025Article
- Social security cuts and life expectancy: a longitudinal analysis of local authorities in England, Scotland and Wales.Journal of epidemiology and community health · 2023Article
- Understanding the Relationship Between Decreases in Social Security Benefits and Intergenerational Inequalities in Mental Health.International journal of social determinants of health and health services · 2023Article
- Identifying opportunities for upstream evaluations relevant to child and maternal health: a UK policy-mapping review.Archives of disease in childhood · 2023Review
- Making better use of natural experimental evaluation in population health.BMJ (Clinical research ed.) · 2022Article
- Exploring the mental health effects of Universal Credit: a journey of co-production.Perspectives in public health · 2022Article
- Trends in healthy life expectancy in the age of austerity.Journal of epidemiology and community health · 2022Article
- Which is most important for mental health: Money, poverty, or paid work? A fixed-effects analysis of the UK Household Longitudinal Study.SSM - population health · 2021Article
- Changing mortality trends in countries and cities of the UK: a population-based trend analysis.BMJ open · 2020Article
- The contribution of changes to tax and social security to stalled life expectancy trends in Scotland: a modelling study.Journal of epidemiology and community health · 2020Article
- Investigating the relationship between changes in social security benefits and mental health: a protocol for a systematic review.BMJ open · 2020Article
- Effects on mental health of a UK welfare reform, Universal Credit: a longitudinal controlled study.The Lancet. Public health · 2020Article
- Is austerity responsible for the recent change in mortality trends across high-income nations? A protocol for an observational study.BMJ open · 2020Article
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Abstract
backgroundIn the UK, lone parents must seek work as a condition of receiving welfare benefits once their youngest child reaches a certain age. Since 2008, the lower age limit at which these Lone Parent Obligations (LPO) apply has been reduced in steps. We used data from a nationally representative, longitudinal, household panel study to analyse the health effects of increased welfare conditionality under LPO.
methodsFrom the Understanding Society survey, we used data for lone mothers who were newly exposed to LPO when the age cutoff was reduced from 7 to 5 years in 2012 (intervention group 1) and from 10 to 7 years in 2010 (intervention group 2), as well as lone mothers who remained unexposed (control group 1) or continuously exposed (control group 2) at those times. We did difference-in-difference analyses that controlled for differences in the fixed characteristics of participants in the intervention and control groups to estimate the effect of exposure to conditionality on the health of lone mothers. Our primary outcome was the difference in change over time between the intervention and control groups in scores on the Mental Component Summary (MCS) of the 12-item Short-Form Health Survey (SF-12).
findingsThe mental health of lone mothers declined in the intervention groups compared with the control groups. For intervention group 1, scores on the MCS decreased by 1·39 (95% CI -1·29 to 4·08) compared with control group 1 and by 2·29 (0·00 to 4·57) compared with control group 2. For intervention group 2, MCS scores decreased by 2·45 (-0·57 to 5·48) compared with control group 1 and by 1·28 (-1·45 to 4·00) compared with control group 2. When pooling the two intervention groups, scores on the MCS decreased by 2·13 (0·10 to 4·17) compared with control group 1 and 2·21 (0·30 to 4·13) compared with control group 2.
interpretationStringent conditions for receiving welfare benefits are increasingly common in high-income countries. Our results suggest that requiring lone parents with school-age children toseek work as a condition of receiving welfare benefits adversely affects their mental health.
fundingUK Medical Research Council, Scottish Government Chief Scientist Office, and National Health Service Research Scotland.
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