Guaranteed income and health in the U.S. and Canada: A scoping review.

Abstract

While the economic impact of guaranteed income (recurring, unconditional, and unrestricted cash transfers intended to supplement the income of participants) is well-studied, much less is known about how guaranteed income may impact health, especially in the context of high-income countries like the U.S. and Canada. We searched five electronic databases for terms related to "guaranteed income" and "cash transfer" through April 23, 2022. Among 5,340 records originally identified, 25 met our inclusion criteria and represented 16 unique guaranteed income initiatives. Most included studies used a quantitative approach (n=22, 88%), were published between 2000-2022 (n=21, 84%), and were in the U.S. (n=15, 60%). Health outcomes included: maternal and child health (e.g., pre-term births, breastfeeding initiation), healthcare utilization (e.g., hospital admissions), mental health (e.g., depression), physical health (e.g., body mass index) and behavioral health (e.g., substance use). Maternal, infant, and child health were most highly represented health outcomes. Guaranteed income initiatives generally had significant positive impacts on health outcomes, with the largest impact seen among the most vulnerable recipients. There was a notable absence of data on neighborhood-level health outcomes, chronic and infectious diseases, potential unintended consequences, and long-term impacts of guaranteed income on health. While studies on the impact of guaranteed income and health studies are few, they suggest guaranteed income has the potential to positively impact many, but not all, health outcomes. Rigorous assessment of health outcomes is still needed, and additional health outcomes should be considered in the design and evaluation of guaranteed income initiatives.