ArticleThe Lancet. Global health2025
Associations between the Bolsa Familia conditional cash transfer programme and substance use disorder hospitalisations: a quasi-experimental study of the 100 Million Brazilian Cohort.
Article in The Lancet. Global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Racial inequities in cervical cancer mortality and the role of the Bolsa Família conditional cash transfer programme: results from the 100 Million Brazilian Cohort.Lancet regional health. Americas · 2026Article
- Cash Transfers and Psychiatric Hospitalization for At-Risk Populations in Brazil.JAMA network open · 2026Article
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Abstract
backgroundAlthough low socioeconomic status is a recognised risk factor for substance use disorders (SUDs), the potential of socioeconomic interventions, such as conditional cash transfer programmes, to mitigate this burden remains poorly explored. Our study investigated whether the Brazilian conditional cash transfer, the Bolsa Familia Program (BFP) was associated with reduced SUD hospitalisations (ie, both admission to and treatment within hospital).
methodsThis quasi-experimental study used national administrative hospitalisation and BFP payroll records linked to the 100 Million Brazilian Cohort baseline from 2008 to 2015. We used Poisson regression models with inverse probability of treatment weighting, using the propensity score, to evaluate the association of the BFP with SUD hospitalisations.
findingsThe study included 35 926 326 individuals registered at baseline from 2008 to 2015. BFP benefit was associated with a lower risk of SUD hospitalisations overall (incidence rate ratios [IRR] 0·83, 95% CI 0·81-0·85). BFP benefit was also associated with both a lower risk of alcohol-related hospitalisations (0·74, 0·71-0·77) and a lower risk of hospitalisations due to other substances except alcohol (0·89, 0·86-0·92). Both male and female beneficiaries had a lower risk of SUD hospitalisation compared with non-beneficiaries. We observed an increased gradient of protection against SUD hospitalisations among beneficiaries of the BFP as municipal deprivation increased. The reduction was 10% (IRR 0·90, 0·87-0·92) in less deprived municipalities and 41% (0·59, 0·49-0·71) in highly deprived municipalities.
interpretationReceiving BFP benefit was associated with lower risk of SUD hospitalisation, implicating conditional cash transfers as a potential tool to respond to SUD-related issues in individuals experiencing poverty. This protective association could be mediated by alleviating poverty, fulfilling basic needs, improving socioeconomic status, enhancing health access, and promoting education.
fundingNational Institute of Mental Health-National Institutes of Health. TRANSLATION: For the Portuguese translation of the abstract see Supplementary Materials section.
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