Welfare reform in the United States

BMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7064.1028 (Published 26 October 1996) Cite this as: BMJ 1996;313:1028
  1. Sarah Purdy, Visiting fellow
  1. Department of Ambulatory Care and Prevention, Harvard Medical School, Boston, MA 02215, USA

    Will have important impacts on the nation's health

    The relation between economic status and health is well known, although the exact factors of the equation are less certain.1 Recent work from the United States2 3 confirms British research suggesting that not only is low income associated with higher mortality and ill health but that the wider the range of income in a population the greater the impact on mortality.

    US president Bill Clinton has signed a bill that will bring huge changes to the federal welfare system in the United States.4 The bill fundamentally changes the organisational framework of the delivery of welfare services. Federal welfare programmes will cease to exist, and savings will be allocated to individual states. Each state will then have the authority to determine who is entitled to benefits and what those benefits are.

    However, the bill does not stop at reorganising the system. The current open ended entitlement to benefits will be …

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