Unconditional Cash Transfers Research Articles

Randomized pilot trial of an unconditional cash transfer intervention to address food insecurity in oncology.

Screening for food insecurity and other social determinants of health is being integrated into oncology practice. We performed a pilot randomized trial to investigate whether an unconditional cash transfer (UCT) could be used to address food insecurity among female breast and gynecologic cancer survivors. Food insecure cancer survivors completed a baseline survey and were randomized to receive $100/month for three months (UCT) or usual care (UC). Participants (n = 14) completed a follow-up survey after 3-months and we compared changes in health-related quality of life, indicators of food insecurity, diet quality, and whether a participant had to forgo, delay, or make changes to medical care because of cost. The UCT was associated with higher physical health scores, fewer indicators of food insecurity, better diet quality, and a lower likelihood of forgoing medical care than those who received UC. Our results suggest that UCTs can improve outcomes for food insecure cancer survivors.

Health effects of introducing an unconditional child benefit in Poland: Evidence from a difference in differences analysis

The association between income and health is well-documented, yet the impact of unconditional child benefits on health in high-income countries remains unclear. This study evaluates the health effects of a generous unconditional child transfer introduced in Poland in 2016. We employed a difference-in-differences methodology using 2010–2019 data from the European Union Statistics on Income and Living Conditions (EU-SILC). Our analysis compared health outcomes between parents eligible for the child benefit and a control group of childless individuals and parents of ineligible children. The introduction of the child benefit was associated with a 2.7 percentage point increase in reporting very good self-perceived health among beneficiaries. The improvement was more significant among the lower-income half, and there was a notable decrease in unmet medical and dental needs by 1.4 percentage points. The policy significantly improved health outcomes, suggesting the potential of unconditional cash transfers to enhance health in high-income countries, particularly for economically disadvantaged groups.

Implications of Cash Transfer Programs for Mental Health Promotion among Families Facing Significant Stressors: Using Ecological Systems Theory to Explain Successes of Conditional and Unconditional Programs.

The purpose of this paper is to apply Bronfenbrenner's ecological systems theory to explore the literature on how Conditional Cash Transfer (CCT) and Unconditional Cash Transfer (UCT) programs might support positive mental health outcomes. The paper begins with transnational considerations of stress, such as poverty and COVID-19, and their impact on mental health. Bronfenbrenner's theory is applied to better understand the mechanisms by which CCT and UCT programs can potentially lead to positive outcomes for children and families who face such stressors. The implications of cash transfer programs are subsequently discussed in terms of how they might promote positive mental health outcomes among families globally. This theoretical application paper concludes with a call for transnational research to explore connections between cash transfer programs and mental health outcomes for children/adolescents and their parents/caregivers.

Estimating the Effect of a Universal Cash Transfer on Birth Outcomes

Babies in the United States fare worse than their peers in other high-income countries, and their well-being is starkly unequal along socioeconomic and racialized lines. Newborn health predicts adult well-being, making these inequalities consequential. Policymakers and scholars seeking to improve newborn health and reduce inequality have recently looked to direct cash transfers as a viable intervention. We examine the only unconditional cash transfer in the United States, the Alaska Permanent Fund Dividend (PFD), to learn if giving pregnant people money improves their newborns’ health. Alaska has paid its residents a significant dividend annually since 1982. The dividend’s size varies yearly and is exogenous to Alaskans and the local economy, permitting us to make causal claims. After accounting for fertility selection, we find that receiving cash during pregnancy has no meaningful effect on newborn health. Current theory focuses on purchasing power and status mechanisms to delineate how money translates into health. It cannot illuminate this null finding. This case illustrates a weakness with current theory: it does not provide clear expectations for interventions. We propose four components that must be considered in tandem to predict whether proposed interventions will work.

The effect of unconditional cash transfers on maternal assessments of children's early language and socioemotional development: Experimental evidence from U.S. families residing in poverty.

Economic disadvantage has often been associated with poorer performance on measures of early childhood development. However, the causal impacts of income on child development remain unclear. The present study uses data from the Baby's First Years randomized control trial to identify the causal impact of unconditional cash transfers on maternal reports of early childhood development. One thousand racially and ethnically diverse mothers residing in poverty were recruited from four U.S. metropolitan areas shortly after giving birth. Mothers were randomized to receive either a $333/month or $20/month unconditional cash transfer for the first several years of their child's life. Maternal reports of language and socioemotional development, concerns for developmental delay, and enrollment in early intervention services were collected annually at the time of the child's first, second, and third birthdays. In this registered report, we document no statistically detectable impacts of the high-cash gift on maternal reports of child development. We discuss the significance and implications of these findings. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Poverty reduction and childhood opportunity moves: A randomized trial of cash transfers to low-income U.S. families with infants

Black and Hispanic children have a higher likelihood of experiencing neighborhood poverty than white children. This study uses data from the Baby's First Years (BFY) randomized trial to examine whether an unconditional cash transfer causes families to make opportunity moves to better quality neighborhoods. We use Intent to Treat linear regression models to test whether the BFY treatment, of receiving $333/month (vs. $20/month) for three years, leads to moves to neighborhoods of greater childhood opportunity. Overall, we find no relation between the BFY treatment and neighborhood opportunity across time. However, we find effect modification by maternal baseline health. High-cash receipt among mothers with poor health at baseline corresponds with moves to neighborhoods of greater childhood opportunity.

Child-directed speech in a large sample of U.S. mothers with low income.

Research on early language input and socioeconomic status typically relies on correlations in small convenience samples. Using data from Baby's First Years, this paper assesses the causal impact of monthly, unconditional cash transfers on child-directed speech and child vocalizations among a large, racially diverse sample of low-income U.S. mothers and their 1-year-olds (N = 563; 48% girls; 2019-2020). The monthly, unconditional cash transfers did not impact mothers' child-directed speech during a 10-min at-home play session (effect sizes range from -.08 to .02), though there was wide variability within this sample. Future work will assess the impact of the continued cash transfer on children's language input and development over time.

Unconditional cash transfers and child schooling: a meta-analysis

Unconditional cash transfers and child schooling: a meta-analysis

The impact of unconditional cash transfers on enhancing household wellbeing in Pakistan: evidence from a quasi-experimental design

Cash transfer programs have emerged as potent tools for alleviating poverty and enhancing the living conditions of the most deprived households in developing nations. Such initiatives have now become integral components of social protection systems in many developing countries, including Pakistan. Evaluating the efficacy of these safety nets is crucial to comprehend their value in terms of public expenditure. This research employed a well-being index to gauge the impact of unconditional cash transfers on the socioeconomics of recipients. By employing three rounds of the BISP impact assessment survey conducted in 2011, 2016, and 2019. The study measured the overall impact of cash transfers on well-being by utilizing Principal Component Analysis in conjunction with a Difference-in-Differences Quasi-Experimental design over the years. The findings of the study indicate that between 2011 and 2016, the socioeconomic status declined for both treatment and control groups, but the reduction was less pronounced among those who received treatment compared to the control group with insignificant. From 2016 to 2019, there was a marginal positive increase in socioeconomic status, although it was of insignificance. Overall, the well-being of both the control and treatment groups decreased from 2011 to 2019, with a slightly more pronounced improvement observed in the treatment group. This trend suggests that the impact of the BISP unconditional cash transfer program had a limited effect on altering the well-being of the beneficiaries. The lack of substantial impact from the BISP’s cash transfers on household well-being can be attributed to factors such as inflation, unemployment, economic slowdown, payment challenges, insufficient funding, and gaps between installments. The government of Pakistan should reconsider the substantial investment in BISP within the context of value for money. It is advisable for the government and policymakers to channel this substantial investment into income generation, capital asset development, microbusinesses, climate-resilient agriculture, and livestock in order to stimulate the real economy sectors.

Evaluating the association between receipt of a winter fuel cash transfer and older people's care needs, quality of life, and housing quality: Evidence from England

BackgroundExposure to cold temperatures is known to be associated with deterioration of physical and mental health as well as poorer well-being in many countries. The Winter Fuel Payment, an unconditional direct cash transfer of value between £250-£300, was designed to help older people in England cover heating costs during the winter months, to counteract the particular vulnerability of older people to the effects of cold weather. AimsWe evaluated the impact of the Winter Fuel Payment scheme on subsequent prevalence of care needs such as being unable to eat or shower independently, quality of life and the likelihood of having cold-related housing conditions. We also explored the potential effects of the Winter Fuel Payment across different sub-samples (poorer/richer individuals, those living in newer/older properties, and in the North/South of England) to explore whether its benefits (if any) are spread equally across the eligible population. Data and methodsWe used a regression discontinuity design approach with age as running variable to analyse seven waves of a nationally representative sample, the English Longitudinal Study of Ageing, covering the period 2002/2003 to 2016/2017, and consisting of 24,651 observations. ResultsThe Winter Fuel Payment had no overall effect on the outcomes of interest (care needs, quality of life, and cold-related housing problems). However, the Payment increased quality of life for poorer individuals, for those living in Northern regions of England, and for those living in newer dwellings. The likelihood of living in a property with at least one cold-related housing problem also decreased for those living in newer properties. ConclusionsFindings from this research provide important insights into the effectiveness of a winter cash transfer among the older population in England, and they are potentially relevant for other nations looking for strategies to deal with cold seasons and poorly insulated homes. In particular, this evaluation contributes to the ‘universality versus targeting’ policy debate and has implications for the development of energy-efficient policies.

Unconditional cash transfers and maternal employment: Evidence from the Baby’s First Years study

How the labor force participation of mothers of young children responds to unconditioned cash support remains an open question in policy debates. Using data from Baby’s First Years, a large-scale randomized controlled study, we generate new estimates of the impact of an unconditional monthly cash transfer on maternal employment behavior through a child’s first four years of life. We find no overall statistically detectable differences in whether mothers participated in the paid workforce or on total household earnings. Receipt of the cash transfer appears to have reduced hours of maternal work during the height of the pandemic in 2020–21.

The impact of welfare design on consumption patterns of the poor: Evidence from the recent Dibao reform in rural China

In the recent anti-poverty campaign, China's minimum livelihood guarantee program (called Dibao in Chinese) experienced significant changes in that it now includes both cash transfer and special assistances such as education and healthcare subsidies. Therefore, the current Dibao program in China is a composite cash transfer program containing the nature of both unconditional and conditional cash transfers. This paper is the first attempt to examine the impact of a composite cash transfer program on consumption patterns of the poor population by utilizing exogenous variation in the differential size of increases in Dibao subsidy lines across cities. We find that the Dibao reform has a significantly positive effect on total consumption of poor households. In particular, the generosity of this composite cash transfer program increased human capital expenditures to a large extent including expenditures on healthcare and children's education. The Dibao reform also generates positive spillovers such as increasing school enrollment and improving academic performance for children in Dibao families.

Effects of a monthly unconditional cash transfer starting at birth on family investments among US families with low income.

How does unconditional income for families in poverty affect parental investments for their young children? Mothers in four US metropolitan areas were randomized to receive a monthly unconditional cash transfer of either $333 per month (high) or $20 per month (low) for the first several years after childbirth. During the first 3 years, high-cash gift households spent more money on child-specific goods and more time on child-specific early learning activities than the low-cash gift group. Few changes were evident in other core household expenditures. Compared with low-cash gift families, high-cash gift families reported lower rates of public benefit receipt and fewer were residing in poverty, although mean income and wealth remain low for the majority of families by year 3. No statistically significant differences were evident in mothers' participation in paid work, children's time in childcare or mothers' subjective wellbeing.

Cash Versus Kind: Benchmarking a Child Nutrition Program Against Unconditional Cash Transfers in Rwanda

Abstract We develop a methodology to benchmark in-kind programs against cost-equivalent cash transfers. Our application compares a multi-dimensional child nutrition intervention to unconditional cash transfers, using randomised variation in transfer amounts and regression adjustment of expenditures to estimate impacts of cash transfers at identical cost as well as to estimate the return to increasing cash transfer amounts. While neither the in-kind program nor a cost-equivalent transfer costing ${\$}$124 per household moves core child outcomes within a year, cash transfers create significantly greater consumption and asset accumulation. A larger cash transfer costing ${\$}$517 substantially improves consumption and investment outcomes and drives modest improvements in dietary diversity and child growth.

Unconditional cash transfer programs and women’s empowerment: evidence from Pakistan

AbstractThis study explores the impact of unconditional cash transfers on the multiple dimensions of women’s empowerment in Pakistan. Emphasizing the importance of cultural and religious norms, empowerment is considered as a latent construct manifested through three distinct choice dimensions, viz., “self,” “familial,” and “economic.” For the empirical estimation, a structural equation model is used on the country-representative Impact Evaluation Survey data of 2015–16 for the Benazir Income Support Program. The measurement model identifies various indicators for the dimensions considered. The results confirm the importance of providing cash transfers to the country's poorest women in all three dimensions, while the impact on self-choices is almost 40% that of the impact on the other two aspects of empowerment. Our findings provide recommendations for the successful implementation of social assistance programs.

Authoritarian welfare and resilience: politics of child benefits in Russia

ABSTRACT Recent literature on authoritarian stability and legitimation has highlighted the role of propaganda and information control, national identity politics, participation technologies and other communication strategies autocrats use to shape public opinion. The authoritarian tool kit is, incomplete if we do not account for governance-related measures. Focusing on authoritarian social policy and contributing to the literature on the authoritarian welfare state, this study measures the political effects of unconditional and conditional cash transfers, specifically focusing on child subsidies, that the Russian government has increasingly integrated into its policy tools. Social policy and child support earn the government political dividends in terms of shoring up public support and have acquired added significance over the last few years. It is part of the current social pact that enables authoritarian resilience during Russia’s war against Ukraine and that is made possible by the actions at the federal, regional, and municipal levels of government.

Cash Transfers and After-School Programs: A Randomized Controlled Trial for Young Men at Risk of Violence Exposure in Wilmington, Delaware

We conducted a randomized controlled trial to determine whether an after-school program paired with a cash transfer (a conditional cash transfer) or a cash transfer alone (an unconditional cash transfer) can help improve health and economic outcomes for young men between the ages of 14 and 17 whose parents have low incomes and who live in neighborhoods with high crime rates. We find that receiving the cash transfer alone was associated with an increase in healthy behaviors (one of our primary outcome composite measures) and that the cash transfer paired with after-school programming was associated with an improvement in the financial health of participants (one of our secondary outcome composite measures). We find no differences in spending on alcohol, marijuana, cigarettes, or other drugs between either the treatment group and the control group. Neither the cash transfer alone nor the programming plus cash transfer had statistically significant effects on our other primary composite measures (physical and mental health or school attendance and disciplinary actions), or our other secondary composite measures (criminal justice engagement or social supports) but in most cases, confidence intervals were too large to rule out meaningful effects. Results suggest that cash transfers hold promise to improve the health of youth without any indication of any adverse effects.

The impact of antiretroviral treatment and child-focused unconditional cash transfers on child mortality

Although there is sufficient evidence in the epidemiological literature that antiretroviral treatment (ART) reduces child mortality, there is limited evidence of its effect in the socio-economic determinants of child mortality literature. Furthermore, evidence on the effect of child focused unconditional cash transfers (UCTs) on child mortality is limited, especially in the African context. Using South Africa's provincial level data over the period 2001 to 2019, we evaluate the effect of ART and child focused UCTs on child mortality. We use the two-stage instrumental variable mean group estimator. We find that ART reduces child mortality. Moreover, we find an inverted U-shaped non-linear relationship between UCTs and child mortality that is contingent to the level of cash transfer coverage. Our analyses also reveal that UCTs improve the effect of ART on child mortality by enhancing access and adherence to treatment. While the focus of our analyses was on the child mortality effects of ART and UCTs, our findings reaffirm the well-documented impacts of factors such as public health expenditure, HIV/AIDS, female education, and health worker density on child mortality. Collectively, the combination of high ART and UCTs coverage, increased public health expenditure, enhanced female education, and improved health worker density, represents value for money for policymakers and funders. These areas should be prioritised to improve child well-being.

Handing Money to the Poor Is Never Enough: The Impact of Marginalization-Related Diminished Returns.

Recent US studies such as Baby's First Years have again demonstrated that unconditional cash transfers and guaranteed income do not lead to significant improvements in the health, economic status, and well-being of individuals living in poverty. In this perspective article we review the emerging literature on this topic and offer explanations for the observed outcomes. We then apply the theory and empirical evidence on marginalization-related diminished returns (MDRs) also called minorities diminished returns (MDRs) to elucidate the weak or null effects of cash transfers in the lives of marginalized populations. According to the MDR theory, marginalization not only reduces access to resources but also reduces their utility. Individuals who experience long-term poverty and marginalization exhibit smaller than expected benefits from new resources, such as cash, in adulthood. This is due to the deeply entrenched structural barriers and systemic discrimination that persist throughout their lives. The existing literature suggests that socioeconomic changes in adulthood have limited impact on the health and well-being of populations that have been raised in poverty. This is because the advantages of increased socioeconomic status (SES) are often undermined by ongoing marginalization and limited access to supportive resources and opportunities. As a result, simply providing cash transfers is insufficient to create substantial and lasting improvements in the lives of those living in poverty. To address these challenges, we recommend a multifaceted approach that includes childhood poverty prevention, interventions aimed at reducing marginalization, and comprehensive multi-sector strategies. By focusing on early intervention and addressing the root causes of poverty and marginalization, we can create more effective and sustainable solutions to improve health and well-being among disadvantaged populations. This holistic approach recognizes the complexity of poverty and the necessity of addressing both immediate needs and long-term structural barriers to achieve meaningful change.

Unconditional cash transfers: Is it possible to reverse the cost of poverty during childhood?

Unconditional cash transfers: Is it possible to reverse the cost of poverty during childhood?