President Joe Biden’s social safety net bill faces a tough road to passage. If it is passed, there’s another challenge ahead: How to get its many programs – providing tax cuts for the middle class, expanding access to affordable housing, higher education, health care coverage and child care – to the people it aims to help. If they do not know about them or do not know how to enroll, the programs won’t do any good.
Older, poorer, less educated and foreign-born people often do not sign up for benefits to which they are entitled because they are unaware of them or do not know how to access them. Already, government agencies are setting up websites to provide information.
Our recent research finds this might not actually be the best way to engage with the people who need this help. We were surprised to learn that postcards were far more effective than setting up phone hotlines, websites or email addresses. Although we conducted our work in 2016, the study wasn’t published until October 2021.
Public service providers have increasingly used websites and hotlines to engage with disadvantaged communities, as they reduce costs and increase convenience.
Many researchers have studied what types of messages work best. But almost no one has examined which methods are most effective. Working with scholars and practitioners, we conducted a field experiment in low-income regions of Greece.
Our goal was to understand how disadvantaged communities perceive the relative costs and benefits of using either a phone hotline, an email, a prepaid postcard or a postcard requiring a stamp to seek information about how to access badly needed health services.
We expected the phone hotline to be the most convenient option. We assumed it would inconvenience only recent immigrants with limited language skills.
Our expectations were wrong.
We partnered with the Prolepsis Institute of Preventive Medicine, Environmental and Occupational Health, a nonprofit that provides free meals in high-need schools across Greece. As part of this program, Prolepsis conducts a regular survey to collect information about students and their families’ nutrition and health needs. Through this survey, we invited 16,456 parents to seek information on free dental care for their children using one of four randomly assigned communication modes: phone hotline, email, prepaid postcard or postcard requiring a stamp.
People who were told to contact Prolepsis through an email address or a phone hotline responded much less frequently than those offered postcards. We found that subjects were 18 times more likely to seek information about dental services when told to use a prepaid postcard and eight times more likely when told to use a postcard requiring postage.
To understand why phone hotlines and emails were so ineffective, we conducted hundreds of interviews and focus groups with parents from the survey. We discovered that, even though phone access is universal and social calls are routine, many people are hesitant to pick up the phone to call a government worker.
Our interviewees believed they lacked the skills to interact with an administrator.
Email was even more challenging, as many reported that they did not have a computer at home or steady internet access.
Reaching disadvantaged communities is a big problem for service providers.
If information about benefits is not communicated in ways familiar and comfortable to high-need groups, welfare benefits will accrue to Americans who know how to claim these services rather than to those in greatest need.
Katerina Linos is a law professor at the University of California Berkeley. Laura Jakli is a junior fellow at Harvard University. Melissa Carlson is a postdoctoral fellow at Stanford University. Distributed by The Associated Press.
