In the 1990s, reforms to welfare and Federal disability insurance programs had two goals: promoting employment among traditional recipients of public income assistance and reducing dependency on public income assistance. Little is known about the impact of these reforms on individuals with substance use disorders (SUDs). This Mentored Research Scientist Award will allow Dr. Ellen Meara, a health economist with expertise in vulnerable populations, to supplement her economic tools to achieve her long-term career goal of becoming an independent investigator on the economics of substance abuse, focusing on the links between social insurance, and social and health outcomes for individuals with SUDs. The proposed training activities aim to: 1) develop an understanding of clinical aspects of SUDs and treatment;2) understand features of reforms to welfare and Supplemental Security Income and Social Security Disability Insurance (SSI/DI), and related public provision of health services;and 3) to supplement knowledge of conceptual and analytic methods relevant for studying the impact of social insurance programs on individuals with SUDs. Dr. Meara proposes to pursue these aims through coursework and tutorials with the guidance of sponsor Dr. Richard Frank, a health economist with expertise in the economics of mental health and substance abuse, co-sponsor, Dr. Shelly Greenfield, a psychiatrist and researcher specializing in addictions, and co-sponsor Dr. Thomas McGuire, a health economist with expertise in economic theory, mental health and substance abuse. The proposed research aims to: 1) determine the impact of reforms to welfare and SSI/DI on employment among low-income individuals with SUDs;2) to determine the impact of these reforms on health outcomes including: substance use and abuse, substance abuse treatment, symptoms of mental illness, and general health outcomes for individuals with SUDs;and 3) to determine how reforms to welfare and SSI/DI influence public program participation and related social costs.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Scientist Development Award - Research & Training (K01)
Project #
5K01DA019485-05
Application #
7616210
Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Duffy, Sarah Q
Project Start
2005-07-15
Project End
2010-06-30
Budget Start
2009-06-01
Budget End
2010-06-30
Support Year
5
Fiscal Year
2009
Total Cost
$164,333
Indirect Cost
Name
Harvard University
Department
Administration
Type
Schools of Medicine
DUNS #
047006379
City
Boston
State
MA
Country
United States
Zip Code
02115
Busch, Susan H; Golberstein, Ezra; Meara, Ellen (2014) The FDA And ABCs: Unintended Consequences Of Antidepressant Warnings On Human Capital. J Hum Resour 49:540-571
Garfield, Rachel L; Beardslee, William R; Greenfield, Shelly F et al. (2012) Behavioral health services in separate CHIP programs on the eve of parity. Adm Policy Ment Health 39:147-57
Cutler, David M; Lange, Fabian; Meara, Ellen et al. (2011) Rising educational gradients in mortality: the role of behavioral risk factors. J Health Econ 30:1174-87
Chatterji, Pinka; Meara, Ellen (2010) Consequences of eliminating federal disability benefits for substance abusers. J Health Econ 29:226-40
Danziger, Sheldon; Frank, Richard G; Meara, Ellen (2009) Mental illness, work, and income support programs. Am J Psychiatry 166:398-404
Meara, Ellen R; Richards, Seth; Cutler, David M (2008) The gap gets bigger: changes in mortality and life expectancy, by education, 1981-2000. Health Aff (Millwood) 27:350-60
Meara, Ellen; Greenfield, Shelley F; Greenfield, Shelley (2008) The relationship between substance use patterns and economic and health outcomes among low-income caregivers and children. Psychiatr Serv 59:974-81
Meara, Ellen (2006) Welfare reform, employment, and drug and alcohol use among low-income women. Harv Rev Psychiatry 14:223-32
Levy, Douglas E; Meara, Ellen (2006) The effect of the 1998 Master Settlement Agreement on prenatal smoking. J Health Econ 25:276-94
Meara, Ellen; Frank, Richard G (2005) Spending on substance abuse treatment: how much is enough? Addiction 100:1240-8