title: More money, fewer lives: the cost effectiveness of welfare reform in the United States.
abstract: OBJECTIVE
  We evaluated the economic benefits of Temporary Assistance to Needy Families (TANF) relative to the previous program, Aid to Families with Dependent Children (AFDC).
  
  
  METHODS
  We used pooled mortality hazard ratios from 2 randomized controlled trials-Connecticut Jobs First and the Florida Transition Program, which had follow-up from the early and mid-1990s through December 2011-and previous estimates of health and economic benefits of TANF and AFDC. We entered them into a Markov model to evaluate TANF's economic benefits relative to AFDC and weigh them against the potential health threats of TANF.
  
  
  RESULTS
  Over the working life of the average cash assistance recipient, AFDC would cost approximately $28000 more than TANF from the societal perspective. However, it would also bring 0.44 additional years of life. The incremental cost effectiveness of AFDC would be approximately $64000 per life-year saved relative to TANF.
  
  
  CONCLUSIONS
  AFDC may provide more value as a health investment than TANF. Additional attention given to the neediest US families denied cash assistance could improve the value of TANF.
authors.affiliation: Peter Muennig, Rishi Caleyachetty, and Zohn Rosen are with the Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY. At the time of this research, Andrew Korotzer was unaffiliated.
authors.forename: Peter
authors.initials: P
authors.lastname: Muennig
authors.forename: Rishi
authors.initials: R
authors.lastname: Caleyachetty
authors.forename: Zohn
authors.initials: Z
authors.lastname: Rosen
authors.forename: Andrew
authors.initials: A
authors.lastname: Korotzer
mesh_terms: D000385:Aid to Families with Dependent Children / Q000191:economics / Q000706:statistics & numerical data; D003237:Connecticut / Q000453:epidemiology; D003362:Cost-Benefit Analysis; D005431:Florida / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D008390:Markov Chains; D009026:Mortality; D012946:Social Welfare / Q000191:economics / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology