Gaps in the welfare state: A role-based model of poverty risk in the U.S.

Abstract

Background Research clearly demonstrates that income matters greatly to health. However, income distribution and its relationship to poverty risk is often misunderstood. Methods We provide a structural account of income distribution and poverty risk in the U.S., rooted in the ‘roles’ that individuals inhabit with relation to the ‘factor payment system’ (market distribution of income to individuals through wages and asset ownership). Principal roles are child, older adult, and, among working-age adults, disabled individual, student, unemployed individual, caregiver, or paid laborer. Moreover, the roles of other members of an individual’s household also influence an individual’s income level. This account implies that 1) roles other than paid laborer will be associated with greater poverty risk, 2) household composition will be associated with poverty risk, and 3) income support policies for those not able to engage in paid labor are critical for avoiding poverty. We test hypotheses implied by this account using 2019 and 2022 U.S. Census Current Population Survey data. The exposure variables in our analyses relate to roles and household composition. The outcomes relate to income and poverty risk. Results In 2019, 40.1 million individuals (12.7% of the population) experienced poverty under the U.S. Census’ Supplemental Poverty Measure. All roles other than paid laborer were associated with greater poverty risk (p < .001 for all comparisons). Household composition, particularly more children and disabled working-age adults, and fewer paid laborers, was also associated with greater poverty risk (p < .001 for all comparisons). Five key policy areas—child benefits, older-age pensions, disability and sickness insurance, unemployment insurance, and out-of-pocket healthcare spending—represented gaps in the welfare state strongly associated with poverty risk. Conclusions The role one inhabits and household composition are associated with poverty risk. This understanding of income distribution and poverty risk may be useful for social policy.

Age at diagnosis and social risks among Black cancer survivors: Results from the Detroit Research on Cancer Survivors cohort

“…39 Poverty and social risks are both more common in households with young children. 40 A cancer diagnosis may further exacerbate the financial precarity of young adults with dependent children.…”

Understanding food insecurity risk in the United States: A longitudinal analysis

“…We used the Supplemental Poverty Measure resources (SPM) income concept for this study. ( US Census Bureaub ) We chose the SPM income concept because it is concordant with international guidelines for income-related research that recommend using an income concept that includes income sources at the household level, includes both factor income and transfer income, is net of taxes, and includes both cash and non-cash (e.g., Supplemental Nutrition Assistance Program [SNAP]) benefits ( Berkowitz & Palakshappa, 2023 ; Brady, 2023 ; Fremsted ). We express income on both a per capita basis (divided by the number of individuals within the household) and on an equivalized basis (divided by the square root of the number of individuals in the household, to account for within-household economies of scale), which is common in international income research ( Brady, 2023 ).…”

“…Following prior work, we categorized participants as inhabiting one mutually exclusive ‘role’ that relates to their connection to the factor payment system ( Berkowitz & Palakshappa, 2023 ; Berkowitz, 2022 ; Technical details for my analysis ). Each participant was categorized into one and only one role for a given year using the following approach.…”

“…In this paper, drawing on a previously published understanding of poverty risk ( Berkowitz & Palakshappa, 2023 ), we present a way to understand food insecurity risk in the U.S ( Fig. 1 ).…”

Food Insecurity and Social Policy: A Comparative Analysis of Welfare State Regimes in 19 Countries

“…All three types of welfare regimes emerged as types of “welfare capitalism”—ways to address the problem that markets as distributive institutions lack a clear mechanism for distributing income to those who neither own assets nor can engage in paid labor. 37 , 45 Historically, corporatist welfare regimes often emerged in the setting of “statism” (efforts by central governments to encourage citizen loyalty and drain support for revolutionary movements), and strong Catholic political parties that sought to both address people's basic needs and reinforce traditional family relationships. 37 , 46 , 47 Liberal regimes emerged in settings of early industrialization, relatively less organized labor movements, and political systems that allowed greater roles for business interests to shape legal arrangements.…”