Cash rewards have a positive impact on low income families' health in New York City, a study found
Cash rewards have a positive impact on low income families’ health in New York City, a study found:
- 4,700 low-income families in New York City have been given cash for three years, conditional on engaging in health-promoting activities like attending school regularly and using preventive health services.
- Compared with controls who did not receive cash transfers, program families had better access to their personal health care providers (+4.2%) and dental check-ups (up to +15%).
- Conditional cash transfer programmes have been proven effective in reducing health inequalities mainly in Latin America and this was the first implementation of such programme in a high-income country. This kind of programme is also gaining ground in Europe.
- Lifepath is a project funded by the European Commission with the aim of investigating the biological pathways underlying social differences in healthy ageing.
Here you can find an infographic explaining conditional cash transfers programmes and the results of Lifepath study.
Milan/Brussels, 5 March 2018 – Lifepath announced the publication of its new study on the health impacts of Opportunity NYC–Family Rewards, a conditional cash transfer programme in New York City aimed at improving population health by making cash transfers conditional on engaging in a number of activities, including school attendance, preventive health care use and employment participation for parents. Family Rewards was the first conditional cash transfer program for low-income families in the US. The study, published in the March issue of Health Affairs, a leading health policy journal, found that Family Rewards had small but meaningful effects on the use of some preventive health services, especially dental care. In addition, the programme had a positive impact on parents’ perceptions of their health as well as their level of hope, mainly through improvements in reported financial well-being. This study is a collaboration between King’s College London, Columbia University and MDRC – a nonprofit, social policy research organization – as part of Lifepath, a project funded by the European Commission with the aim of investigating the biological pathways underlying social differences in healthy ageing.
Dr. Emilie Courtin, Research Fellow at the Department of Global Health and Social Medicine, King’s College London (UK), and her colleagues found that participation in the program was associated with an increased probability of having had at least two dental check-ups in the past year (by 13% in adults and by almost 15% in children 42 months after the program started). This is a very important effect, as oral health care is one of the largest unmet health care needs in the US, and the single largest among children. Family Rewards also had positive effects on health insurance coverage and receiving treatment for any medical condition. Participants were also less likely to forgo medical care due to cost. These effects translated into modest improvements in health status as measured by parental self-rated health and level of hope.
Family Rewards was created by the New York City’s Center for Economic Opportunity (now NYC Opportunity) in partnership with MDRC and Seedco. It was privately funded and offered to more than 4,700 low-income families in six of New York City’s most deprived communities – two each in the boroughs of the Bronx, Brooklyn and Manhattan. It operated from 2007 to 2010 and distributed a total of $20.6 million in cash transfers to participating families, with an average of $8,674 per household. So far, the programme had already shown positive effects regarding reduction in poverty and material hardship, and improvement in perceived financial well-being and graduation rates for children. This new study further explores its effects on health and health care use.
“On top of New York City’s strong existing social safety net, Family Rewards has led to some improvements in health care access and perceived health of poor families” said Dr. Emilie Courtin, lead author of the study. Dr. Courtin added “A key strength of the study is its design. Family Rewards was evaluated in a randomized-controlled trial – the gold standard for finding out if a program like this works.”
Conditional cash transfer programmes: Latin American invention, worldwide consolidation
Conditional cash transfer programmes are becoming a prevalent policy for improving the education and health outcomes of poor children in developing countries, since their introduction in Mexico and Brazil in 1997. They have been implemented with the support of the World Bank and other international financial institutions in many countries, particularly in South East Asia and Latin America.
Conditional cash transfer programmes aim to increase human capital investment among poor households to break the intergenerational transmission of poverty and generate individual as well as societal benefits. Interventions across Latin America have led to significant increases in the use of health services, including the number of visits to health facilities and receipt of prenatal care and paediatric examinations. Evidence shows that the interventions have also improved some health outcomes – in particular, developmental, nutritional and cognitive measures among children.
“Strong evidence on what works, and also what doesn’t work, is essential for understanding the potential and limitations of conditional cash transfer programs,” said James Riccio of MDRC. “Conditional cash transfer programmes have been increasingly popular in low- and middle-income countries in Latin America, Africa and Asia,” explained Professor Paolo Vineis, Chair of Environmental Epidemiology within the School of Public Health at Imperial College London and co-ordinator of the Lifepath project. “However, programmes with different types of behavioural conditionality are also gaining ground in various developed countries. Our study can help bring lessons, positive and negative, and inform the design of similar experiments in Europe.”
Journalists can access the full-text paper at this link, using the username healthaffairs and the password M3dia.
Lifepath is an EU-funded project aimed to provide updated, relevant and innovative evidence for the relationship between social inequalities and healthy ageing to lay ground for the development of future health policies and strategies. Lifepath experts develop an original study design that integrates social science approaches with biology and big data analysis, using existing population cohorts and omics measurements.
Media resourcesAdditional information, photos and videos about the project can be found in online Media Centre of Lifepath project.
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