Contributing Factors to the Spread of Sexually Transmitted Diseases: The Case of Welfare

Economists have long studied the determinants and effects of income transfers. This article examines an indirect effect of welfare payments on participating individuals: an increase in the incidence of sexually transmitted disease (STD) rates. Several studies have found a significant and positive link between the size of welfare benefits and out-of-wedlock fertility rates. Higher welfare payments reduce the cost of bearing and raising a child, and thus reduce the full cost of engaging in unprotected sex. An unintended consequence of unprotected sex is exposure to contagious diseases. This implies that states with higher welfare payments per child will experience higher rates of STDs. We test this hypothesis using statewide data on the incidence of three types of bacterial STDs, chlamydia, gonorrhea, and syphilis, for the years 1994 through 1998. The empirical specification is based on the standard microeconomic model of utility-maximizing behavior. The included explanatory variables are demographic proxies reflecting differences in state population characteristics. These characteristics capture unobservable or intrinsically unmeasureable differences in the perceived costs and benefits of engaging in unprotected sex. The explanatory variable of primary interest is the size of the real welfare payment per recipient. Our empirical results indicate that states with higher real welfare payments are associated with greater rates of STDs.