Funding: NIAAA R21 AA12159
This study expanded health services analyses of the NIAAA-funded Welfare Client Longitudinal Study, one of the only longitudinal data sets currently available that allows for in-depth investigations of the relationships between alcohol problems and subsequent dependency on public services in representative samples of welfare recipients. Samples of individuals in the Aid to Families with Dependent Children (AFDC) and General Assistance (GA) programs throughout a large Northern California County were interviewed in 1989 as they applied for welfare services, and were then followed and re-interviewed in 1995. Secondary analyses of these data examined the roles that problem drinking and drug use play in promoting patterns of welfare dependency and long-term unemployment through by focusing at the level of service entry and exit events. In particular, the study examined the degree to which alcohol problems make individuals prone to repeat welfare dependency, and to patterns of welfare use characterized by short lengths of stay, adverse circumstances at the time of leaving the welfare system, exits from welfare into unstable employment situations, and ultimately, welfare returns. Key substantive goals of the project were to develop event history models of exits and returns to welfare that bring about a better understanding of the role that alcohol problems play in these service dynamics. Analyses also considered the roles that different kinds of social service and alcohol treatment interventions play in successful exits from welfare, and in altering patterns of repeat dependency over time. The validity and precision of these findings were informed by two additional kinds of methodological analysis. First, by linking self-report data with administrative records data on the same individuals, the study bridged the gap between administrative records and self-report studies, examining the validity of these two alternative approaches to studying histories of service utilization. Second, by developing classifications of alcohol- and drug-related circumstances leading to recipients’ first exit from welfare, the study produced more refined measures of reasons for exiting welfare, and more generally, gained insight into how alcohol enters into the circumstances by which people leave the welfare system during exit events.