Income Shocks and Adolescent Mental Health

We investigate the effects of a positive income shock on mental health among adolescent girls using evidence from a cash transfer experiment in Malawi. Offers of cash transfers strongly reduced psychological distress among baseline schoolgirls. However, these large beneficial effects declined with increases in the transfer amount offered to the parents conditional on regular school attendance by the adolescent girls. Improved physical health, increased school attendance, personal consumption, and leisure contributed to the effects. There was also strong evidence of increased psychological distress among untreated baseline schoolgirls in treatment areas. All of these effects dissipated soon after the program ended. Gender Connection Gender Focused Intervention Gender Outcomes Psychological agency IE Design Clustered Randomized Control Trial (Clustered at Enumeration Area level) Intervention There were three treatment arms. The CCT arm provided a monthly payment that varied randomly from $4-10 per month to parents and $1-5 per month to the child conditioned on regular school attendance. The UCT arm was identical to the CCT except there was no condition on attendance. Intervention Period Monthly transfers were made from 2008 to the end of 2009; in total the intervention lasted 2 years Sample population The sample was gathered from the Zomba District in Souther Malawi. The district is divided into 550 enumeration areas, each having about 250 households. 176 enumeration areas were selected. A listing of all never-married females aged 13-22 was selected. The sample was stratified into baseline dropouts and baseline schoolgirls. In total there were 3,796 young women and an average of 5.1 dropouts and 16.5 schoolgirls per EA. In 88 Enumeration areas all baseline dropouts were offered conditional cash transfers. The 88 treatment enumeration areas were then randomly divided into 3 treatment groups for school girls; in 46 EAs schoolgirls received a conditional cash transfer, in 27 EAs they received unconditional cash transfer and in 15 EAs no schoolgirl received a transfer. Comparison conditions The study compares girls receiving conditional cash transfers, unconditional cash transfer and no cash transfer. The study also compares different sizes of conditional and unconditional cash transfers. Unit of analysis Individual Level Evaluation Period Baseline data was collected between October 2007 and January 2008, the first follow up data was collected 12 months later, the second follow up data was collected after the completion of the intervention. Results While the intervention was ongoing, baseline schoolgirls who were offered unconditional cash transfers were about 14 p.p. less likely to be suffering from psychological distress than the control group. Those who were offered conditional cash transfers also had a significant reduction in psychological distress, but the impact (6 p.p.) was significantly smaller P ub lic D is cl os ur e A ut ho riz ed P ub lic D is cl os ur e A ut ho riz ed P ub lic D is cl os ur e A ut ho riz ed P ub lic D is cl os ur e A ut ho riz ed enGender Impact: The World Bank’s Gender Impact Evaluation Database Last updated: 14 August 2013 2 than the unconditional cash transfer. For conditional cash transfer, additional size of the transfer leads to an increase in psychological distress. There was also a significant increase in psychological distress among school girls who lived in treatment areas but were not invited to participate in the program, and a decrease among female siblings of schoolgirls who had been offered the transfer. Primary study limitations The cutoff scores for the mental health survey were not validated in Malawi. Funding Source Global Development Network, Bill and Melinda Gates Foundation, NBER Africa Project, #IE Open Window, the World Bank Reference(s) Baird, S., De Hoop, J., & Özler, B. (2013). Income shocks and adolescent mental health. Journal of Human Resources, 48(2), 370-403. Link to Studies http://jhr.uwpress.org/content/48/2/370.short Microdata http://microdata.worldbank.org/index.php/catalog/1005http://microdata.worldbank.org/index.php/catalog/1005