流行病时期现有社会保护计划对心理健康的重要性

YoonyoungChoandTeresaMolina Abstract UsingpaneldatafromthePhilippinesaroundtheonsetoftheCOVID-19pandemic,thispapercomparesde-pressionratesamongbeneficiariesofanexistingsocialprotectionprogram(aconditionalcashtransferprogramknownasthe4Ps)tonon-beneficiariesofsimilarsocioeconomicstatus.Depressionrateswerelowandalmostidenticalforthetwogroupsinlate2019.Theyincreaseddramaticallyforbothgroupsbutweresignificantlylowerfor4PsbeneficiariesbyJuly2020,aftertheinitiationofstrictquarantinemeasuresandthedistributionoflargeemergencycashtransferstobothgroups.Thefindingssuggestthatthe4Psprogrammatteredmoreformentalhealthduringthecrisis,fortwopossiblereasons.First,regularcashsupportmightbecomemorevalu-ableintimesofeconomichardshipanduncertainty.Second,theexistingprograminfrastructurecanimprovetheeffectivenessofagovernment’scrisisresponse—inthiscase,byallowingformoretimelydistributionofemergencycashtothosealreadypartofthesocialprotectionsystem. JELclassification:I38,I31,H12 Keywords:socialprotection,cashtransfers,crisis,mentalhealth 1.Introduction Alargeandgrowingliteraturedocumentsthatcashtransferscanimprovementalhealth.Whilemuchoftheearlierevidenceonthistopiccomesfromresearcher-drivencash-transferexperiments(Baird,DeHoop,andÖzler2013;HaushoferandShapiro2016),thereisnowsubstantialevidencestemmingfromevalua-tionsofgovernment-runsocialprotectionprograms.1However,whatweknowaboutthementalhealthbenefitsofgovernmentsocialprotectionprogramsderivesalmostexclusivelyfromevaluationsconductedin“normal” times.Littleisknownabouthowthesebenefitsmaydifferintimesofcrisis. YoonyoungChoisSeniorEconomistintheSocialProtectionGlobalPracticeattheWorldBank,WashingtonDC,USA;heremailaddressisycho1@worldbank.org.TeresaMolina(correspondingauthor)isaprofessorattheUniversityofHawaiiatManoa,Honolulu,USA;heremailaddressistmolina@hawaii.edu.ThisworkwassupportedbytheDepartmentofForeignAffairsandTradeoftheAustraliangovernment.TheauthorsthankJeffBloem,PamelaMedinaQuispe,andseminarpartic-ipantsatthePhilippineEconomicSocietyAnnualConference,IFPRI,AteneodeManila,theAsianEconomicDevelopmentConference,KyotoUniversity,ANU-ADBIWorkshoponDevelopmentinthePacific,andUHManoaforinsightfulcommentsandLailaMostello-Wetherbeeforexpertresearchassistance.Thefindings,interpretations,andconclusionsexpressedinthispaperdonotnecessarilyreflecttheviewsoftheWorldBank,theExecutiveDirectorsoftheWorldBankorthegovernmentstheyrepresent.AsupplementaryonlineappendixisavailablewiththisarticleattheWorldBankEconomicReviewwebsite. 1See,forexample,thestudiesreviewedinseveralmeta-analyses(McGuire,Kaiser,andBach-Mortensen2022;Wollburgetal.2023;Zimmermanetal.2021). Understandinghowthementalhealthbenefitsofsocialprotectionmightchangeincrisistimesisim-portantbecausesocietiesfaceadrasticallydifferentmentalhealthandpolicylandscapeduringacrisis.Forexample,theCOVID-19pandemic,alongwiththeaccompanyingeconomicturmoilandmobilityre-strictions,hadlargedetrimentaleffectsonmentalhealthacrosstheglobe(Bauetal.2022;Altindag,Erten,andKeskin2022;Brodeuret al.2021;Brülhartet al.2021;Adams-Prasslet al.2022;El-Zoghby,Soltan,andSalama2020;Baranovet al.2022).Atthe same time,most governments respondedby adapting orintroducingnewsocialprotectionpolicies,withcashtransfersemergingasthemostpopularapproach(Gentilinietal.2022). Becauseofthesefactors—boththeenormousshocktomentalhealthandthedrasticgovernmentresponse—itisnotclearwhetherexistingsocialprotectionprogramsbecomemoreorlessimportantformentalhealthduringacrisis.Ontheonehand,ifthemagnitudeofthementalhealthshockissimplytoolarge,orifthenewgovernmentpoliciesenduptakingprecedenceduetotheirscale,existingsocialprotectionprogramsmightbecomelessimportantduringacrisis.Ontheotherhand,ifthebenefitsofsocialprotectionincreasewithlevelsofeconomicandsocialturmoil,orifexistingprogramsenhancetheeffectivenessofnewemergencyprograms,wemightexpecttoseelargermentalhealthbenefitsofexistingsocialprotectionprogramsduringatimeofcrisis.Ahandfulofstudieshaveexaminedthementalhealtheffectsofexistingsocialprotectionprograms duringtheCOVID-19pandemicandhavefoundpositiveeffects.2PensionprogramsinBoliviaandSouthAfricasignificantlyimprovedmentalwell-being(Bottan,Hoffmann,andVera-Cossio2021;Alloush,Bloem,andMalacarne2022).An ongoing universal basicincome randomized controlled trial (RCT)inKenya(whichstartedtwoyearsbeforethepandemic)documentedimprovementsindepressionduetothetransfers(Banerjeeetal.2020).Allthreestudiesfindlargereffectsonhungerduringthepandemiccomparedtonon-pandemictimes,andgiventhewell-documentedlinkbetweenfoodinsecurityandmen-talhealth(AlloushandBloem2022;ColeandTembo2011;Pourmotabbedetal.2020;Jones2017;Fang,Thomsen,andNayga2021;Rahman,Hasnain,andIslam2021),thereisreasontopredictthatthemen-talhealthbenefitsofgovernmentsocialprotectionprogramsmightalsobelargerinpandemictimes.3However,Banerjeeetal.(2020)reportfindingsimilarestimateswhentheycomparetheeffectsofcashonmentalhealthbeforethepandemictoeffectsduringthepandemic.Alloush,Bloem,andMalacarne(2022),whichstudyanationwidegovernmentpro