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The Health Impacts of the Social Safety Net

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This project will build a groundbreaking, foundational database to study the impacts of safety-net programs on health and wellbeing. This initiative will provide important evidence for legislators, policy makers, and health care organizations, among others.


A wealth of evidence suggests that participating in social safety-net programs can dramatically improve peoples’ health and wellbeing. However, studies exploring these relationships have historically been restricted by small samples, self-reported data, and short timeframes. Those limitations make it difficult to understand the effects over time and across policy areas. This project addresses those shortcomings by linking data together from multiple agencies and across a much longer time horizon. Our linkage will enable researchers to produce new insights regarding the impacts of social safety-net programs and policies on health and well-being.

Research Project

Status: ongoing

CPL is building a multi-agency database using vital statistics records (birth/death), health care records (emergency department, hospitalization, and ambulatory surgery claims), as well as enrollment in social safety net enrollment programs such as CalFresh (SNAP) and CalWORKs (TANF). We’ll use this sophisticated database to explore the short- and long-term health impacts of California’s safety net policies and programs. The linkage is highly complex and builds upon CPL’s work over several years to streamline the process of creating “hashed linkages,” which enable us to connect data across agencies without needing access to personally identifying information. This project is supported by Tipping Point Community, Doris Duke Foundation, Blue Shield of California Foundation, and The California Collaborative for Pandemic Recovery and Readiness Research (CPR3).

The linked database will be used for a wide variety of projects. Examples include:

The 2021 Child Tax Credit and Family Health and Economic Outcomes. In this project we will examine how the temporary expansion of the federal Child Tax Credit in 2021 affected the health of California’s most vulnerable families. More specifically, we will explore rates of preventable hospitalizations and emergency department visits among eligible safety net program recipients following tax credit disbursement.

SNAP Benefits and Maternal and Infant Health. In this project we will assess how SNAP benefits impact maternal and infant health. Priority outcomes will include: maternal engagement with prenatal care, pregnancy and birth complications, infants’ birth weight, maternal weight gain, and maternal and infant mortality.

Research Team

Evan White (Principal Investigator), Dr. Erika Brown (co-Principal Investigator), Professor Rita Hamad, MD, PhD (co-Principal Investigator), Professor Hilary Hoynes (co-Principal Investigator), Nikta Akhavan, Huizhi Gong, Sarah Hoover, Alan Perez



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